Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $114.48 / $249.57	Facility		$112.45	$114.48	$249.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $114.48 / $199.43	Professional		$112.45	$114.48	$199.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $183.07 / $412.69	Facility		$112.45	$183.07	$412.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $112.45 / $221.17	Facility		$112.45	$112.45	$221.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $106.09 / $112.45	Facility		$106.09	$106.09	$112.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.75 / $203.96 / $203.96	Professional		$132.75	$203.96	$203.96
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $196.79	Professional		$112.45	$112.45	$196.79