Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $141.60 / $207.27	Facility		$141.00	$141.60	$207.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $143.02 / $170.61	Professional		$141.60	$143.02	$170.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $230.52 / $519.66	Facility		$141.60	$230.52	$519.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.29 / $141.60 / $141.60	Professional		$122.29	$141.60	$141.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $141.60 / $277.54	Facility		$141.60	$141.60	$277.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.59 / $133.59 / $141.60	Facility		$133.59	$133.59	$141.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $297.00 / $460.00	Professional		$111.00	$297.00	$460.00
United Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $158.07	Professional		$141.60	$141.60	$158.07