Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.80 / $62.15 / $67.12	Facility		$61.80	$62.15	$67.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $62.40 / $75.20	Professional		$61.80	$62.40	$75.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.80 / $100.61 / $226.81	Facility		$61.80	$100.61	$226.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $61.80 / $63.03	Professional		$61.80	$61.80	$63.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.80 / $61.80 / $121.56	Facility		$61.80	$61.80	$121.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.28 / $55.28 / $61.80	Facility		$55.28	$55.28	$61.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $61.80 / $61.80	Professional		$61.80	$61.80	$61.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.20 / $293.00 / $427.00	Professional		$169.20	$293.00	$427.00
United Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $61.80 / $250.37	Professional		$61.80	$61.80	$250.37