Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.52 / $158.91 / $158.91	Facility		$134.52	$158.91	$158.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $167.36	Professional		$158.91	$158.91	$167.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $172.43 / $172.43	Facility		$158.91	$172.43	$172.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.41 / $158.91 / $158.91	Professional		$133.41	$158.91	$158.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $135.08 / $158.91 / $312.58	Facility		$135.08	$158.91	$312.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $135.08 / $135.08 / $135.08	Professional		$135.08	$135.08	$135.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.91 / $149.91 / $158.91	Facility		$149.91	$149.91	$158.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Professional		$158.91	$158.91	$158.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.59 / $163.06 / $237.18	Professional		$118.59	$163.06	$237.18
United Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $243.15	Professional		$63.57	$158.91	$243.15