Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.36 / $159.36 / $159.36	Facility		$159.36	$159.36	$159.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.60 / $159.36 / $159.36	Professional		$153.60	$159.36	$159.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $173.60 / $173.60	Facility		$160.00	$173.60	$173.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $182.40 / $182.40	Professional		$160.00	$182.40	$182.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $168.00 / $329.28	Facility		$163.19	$168.00	$329.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $163.19 / $163.19	Facility		$160.00	$163.19	$163.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $373.00 / $578.00	Professional		$160.00	$373.00	$578.00
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $176.52	Professional		$160.00	$160.00	$176.52