Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,606.80 / $2,606.80 / $6,963.10	Facility		$2,606.80	$2,606.80	$6,963.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,606.80 / $3,410.40 / $3,763.20	Professional		$2,606.80	$3,410.40	$3,763.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $804.79 / $3,920.00 / $13,563.20	Facility		$804.79	$3,920.00	$13,563.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $335.33 / $335.33 / $3,920.00	Professional		$335.33	$335.33	$3,920.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,920.00 / $5,488.00 / $8,428.00	Facility		$3,920.00	$5,488.00	$8,428.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,920.00 / $4,704.00 / $5,096.00	Professional		$3,920.00	$4,704.00	$5,096.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,363.32 / $7,898.00 / $12,087.53	Facility		$5,363.32	$7,898.00	$12,087.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,960.00 / $9,486.40 / $10,231.20	Professional		$1,960.00	$9,486.40	$10,231.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $3,795.48 / $9,149.76	Professional		$2,627.64	$3,795.48	$9,149.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4,343.89 / $5,488.00 / $6,997.20	Professional		$4,343.89	$5,488.00	$6,997.20
United Facility/Professional Professional Modifier Low / Median / High Price $1,646.40 / $2,352.00 / $8,072.85	Professional		$1,646.40	$2,352.00	$8,072.85