Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.70 / $114.54 / $143.62	Facility		$97.70	$114.54	$143.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $115.68 / $209.60	Professional		$114.54	$115.68	$209.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $186.47 / $420.36	Facility		$114.54	$186.47	$420.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $116.83	Professional		$114.54	$114.54	$116.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $114.54 / $225.29	Facility		$114.54	$114.54	$225.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $108.05 / $114.54	Facility		$108.05	$108.05	$114.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Professional		$114.54	$114.54	$114.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.35 / $295.04 / $295.04	Professional		$101.35	$295.04	$295.04
United Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $200.45	Professional		$114.54	$114.54	$200.45