Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $82.37 / $490.67	Facility		$69.73	$82.37	$490.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $99.67	Professional		$69.73	$69.73	$99.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $75.66 / $75.66	Facility		$69.73	$75.66	$75.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $71.12	Professional		$69.73	$69.73	$71.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $69.73 / $137.15	Facility		$69.73	$69.73	$137.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $59.27 / $59.27	Professional		$59.27	$59.27	$59.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.78 / $65.78 / $69.73	Facility		$65.78	$65.78	$69.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $95.63	Professional		$69.73	$69.73	$95.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.39 / $107.91 / $127.02	Professional		$79.39	$107.91	$127.02
United Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $69.73 / $134.82	Professional		$27.89	$69.73	$134.82