Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.22 / $60.86 / $98.48	Professional		$51.22	$60.86	$98.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.92 / $117.92 / $117.92	Facility		$117.92	$117.92	$117.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.86 / $95.43 / $199.45	Professional		$8.86	$95.43	$199.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.54 / $88.56 / $190.12	Facility		$10.54	$88.56	$190.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.02 / $75.18 / $118.08	Professional		$10.02	$75.18	$118.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.15 / $78.15 / $78.15	Facility		$78.15	$78.15	$78.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.43 / $78.15 / $138.00	Professional		$66.43	$78.15	$138.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.87 / $117.92 / $236.69	Professional		$13.87	$117.92	$236.69
United Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $64.08 / $114.34	Professional		$40.38	$64.08	$114.34