Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.68 / $47.68 / $135.05	Facility		$47.68	$47.68	$135.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $61.08 / $76.29	Professional		$47.68	$61.08	$76.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.45 / $160.22 / $420.03	Facility		$114.45	$160.22	$420.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $95.17 / $182.73	Professional		$61.08	$95.17	$182.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.43 / $97.28 / $211.73	Facility		$94.43	$97.28	$211.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.28 / $97.28 / $97.28	Professional		$97.28	$97.28	$97.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.38 / $90.38 / $90.38	Facility		$90.38	$90.38	$90.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.81 / $76.81 / $132.00	Professional		$76.81	$76.81	$132.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $114.45 / $184.49	Professional		$86.98	$114.45	$184.49
United Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $57.10 / $95.17	Professional		$38.07	$57.10	$95.17