Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $91.11 / $133.93	Facility		$86.38	$91.11	$133.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $87.25 / $125.73	Professional		$86.38	$87.25	$125.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $140.63 / $317.01	Facility		$86.38	$140.63	$317.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $92.98	Professional		$86.38	$86.38	$92.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $86.38 / $169.89	Facility		$86.38	$86.38	$169.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $81.48 / $86.38	Facility		$81.48	$81.48	$86.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.38 / $532.70 / $532.70	Professional		$136.38	$532.70	$532.70
United Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $132.16	Professional		$86.38	$86.38	$132.16