Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.03 / $23.03 / $65.22	Facility		$23.03	$23.03	$65.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $32.67 / $38.46	Professional		$23.03	$32.67	$38.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.27 / $77.38 / $202.84	Facility		$55.27	$77.38	$202.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $45.96 / $88.24	Professional		$29.48	$45.96	$88.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.98 / $53.54 / $102.25	Facility		$46.98	$53.54	$102.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.98 / $46.98 / $46.98	Professional		$46.98	$46.98	$46.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $34.54 / $34.54	Facility		$34.54	$34.54	$34.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $34.54 / $64.13	Professional		$25.21	$34.54	$64.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.01 / $55.27 / $100.24	Professional		$42.01	$55.27	$100.24
United Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $27.58 / $45.49	Professional		$21.59	$27.58	$45.49