Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,413.92 / $1,413.92 / $3,776.78	Facility		$1,413.92	$1,413.92	$3,776.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,413.92 / $1,807.27 / $2,041.15	Professional		$1,413.92	$1,807.27	$2,041.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.04 / $2,126.19 / $2,726.51	Facility		$22.04	$2,126.19	$2,726.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.28 / $13.28 / $2,126.19	Professional		$13.28	$13.28	$2,126.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,126.19 / $3,082.99 / $4,569.83	Facility		$2,126.19	$3,082.99	$4,569.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,764.06 / $4,677.64 / $6,555.78	Facility		$2,764.06	$4,677.64	$6,555.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11,967.80 / $11,967.80 / $11,967.80	Professional		$11,967.80	$11,967.80	$11,967.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,913.58 / $2,338.82 / $2,976.68	Professional		$1,913.58	$2,338.82	$2,976.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,785.32 / $2,976.68 / $3,933.47	Professional		$2,785.32	$2,976.68	$3,933.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,913.58 / $1,913.58 / $2,126.19	Facility		$1,913.58	$1,913.58	$2,126.19
United Facility/Professional Professional Modifier Low / Median / High Price $893.00 / $1,275.72 / $3,721.91	Professional		$893.00	$1,275.72	$3,721.91