Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $501.19	Facility		$169.82	$169.82	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $194.98 / $363.08	Professional		$169.82	$194.98	$363.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,000.00 / $1,548.82	Facility		$416.87	$1,000.00	$1,548.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $524.81	Professional		$218.78	$346.74	$524.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $676.08	Facility		$239.88	$239.88	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $501.19	Professional		$173.78	$173.78	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $416.87 / $575.44	Professional		$275.42	$416.87	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $275.42 / $295.12	Facility		$141.25	$275.42	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $354.81	Professional		$138.04	$204.17	$354.81