Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.05 / $90.36 / $126.14	Professional		$76.05	$90.36	$126.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.99 / $149.99 / $149.99	Facility		$149.99	$149.99	$149.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.70 / $134.58 / $296.13	Professional		$13.70	$134.58	$296.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.53 / $18.52 / $188.69	Facility		$14.53	$18.52	$188.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $14.53 / $18.60	Professional		$14.53	$14.53	$18.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.17 / $64.17 / $139.79	Facility		$64.17	$64.17	$139.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.43 / $64.17 / $202.50	Professional		$13.43	$64.17	$202.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.53 / $169.74 / $291.00	Professional		$24.53	$169.74	$291.00
United Facility/Professional Professional Modifier Low / Median / High Price $48.12 / $100.39 / $181.70	Professional		$48.12	$100.39	$181.70