Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.06 / $170.48 / $245.58	Facility		$167.06	$170.48	$245.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.06 / $170.48 / $202.14	Professional		$167.06	$170.48	$202.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.48 / $277.54 / $625.66	Facility		$170.48	$277.54	$625.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $173.88	Professional		$170.48	$170.48	$173.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.48 / $170.48 / $335.32	Facility		$170.48	$170.48	$335.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.83 / $160.83 / $170.48	Facility		$160.83	$160.83	$170.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.11 / $22.11 / $543.58	Professional		$22.11	$22.11	$543.58
United Facility/Professional Facility Modifier Low / Median / High Price $953.26 / $953.26 / $953.26	Facility		$953.26	$953.26	$953.26
United Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $260.83	Professional		$170.48	$170.48	$260.83