Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $104.95 / $154.28	Facility		$104.73	$104.95	$154.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.95 / $126.99	Professional		$104.73	$104.95	$126.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $170.50 / $384.36	Facility		$104.73	$170.50	$384.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $104.73 / $205.27	Facility		$104.73	$104.73	$205.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $98.80 / $104.73	Facility		$98.80	$98.80	$104.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $479.00 / $743.00	Professional		$92.03	$479.00	$743.00
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $124.61	Professional		$104.73	$104.73	$124.61