Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $111.51	Facility		$75.86	$75.86	$111.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $91.79	Professional		$75.86	$75.86	$91.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $123.50 / $278.41	Facility		$75.86	$123.50	$278.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $75.86 / $75.86	Professional		$65.20	$75.86	$75.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $148.69	Facility		$75.86	$75.86	$148.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.56 / $71.56 / $75.86	Facility		$71.56	$71.56	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.32 / $77.00 / $119.00	Professional		$51.32	$77.00	$119.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $94.26	Professional		$75.86	$75.86	$94.26