Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.35 / $86.35 / $86.35	Facility		$86.35	$86.35	$86.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.23 / $86.35 / $86.35	Professional		$83.23	$86.35	$86.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $94.07 / $94.07	Facility		$86.70	$94.07	$94.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $98.84 / $98.84	Professional		$86.70	$98.84	$98.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $91.04 / $178.43	Facility		$88.43	$91.04	$178.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $118.43 / $118.43	Professional		$88.43	$118.43	$118.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $104.04	Professional		$86.70	$86.70	$104.04