Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $205.28 / $301.76	Facility		$204.61	$205.28	$301.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $206.66 / $1,454.18	Professional		$204.61	$206.66	$1,454.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $327.38 / $750.92	Facility		$204.61	$327.38	$750.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.83 / $204.61 / $204.61	Professional		$200.83	$204.61	$204.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.61 / $204.61 / $402.45	Facility		$204.61	$204.61	$402.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.03 / $193.03 / $204.61	Facility		$193.03	$193.03	$204.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $204.61	Professional		$204.61	$204.61	$204.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.23 / $226.12 / $376.00	Professional		$194.23	$226.12	$376.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $204.61 / $216.46	Professional		$81.84	$204.61	$216.46