Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.35 / $256.68 / $646.07	Facility		$123.35	$256.68	$646.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $124.60 / $164.52	Professional		$123.36	$124.60	$164.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.36 / $133.85 / $133.85	Facility		$123.36	$133.85	$133.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.68 / $123.36 / $123.36	Professional		$98.68	$123.36	$123.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.36 / $123.36 / $241.79	Facility		$123.36	$123.36	$241.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.38 / $116.38 / $123.36	Facility		$116.38	$116.38	$123.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $123.36 / $123.36	Professional		$123.36	$123.36	$123.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $74.95 / $125.83	Professional		$74.95	$74.95	$125.83
United Facility/Professional Facility Modifier Low / Median / High Price $144.13 / $393.97 / $393.97	Facility		$144.13	$393.97	$393.97
United Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $123.36 / $139.34	Professional		$123.36	$123.36	$139.34