Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.93 / $2,438.00 / $6,705.00	Facility		$133.93	$2,438.00	$6,705.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $132.11 / $251.77	Professional		$71.86	$132.11	$251.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $188.28 / $188.28 / $188.28	Professional		$188.28	$188.28	$188.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.79 / $144.36 / $249.42	Professional		$90.79	$144.36	$249.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.14 / $85.69 / $365.05	Facility		$69.14	$85.69	$365.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $118.64 / $123.56	Professional		$101.41	$118.64	$123.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $162.44 / $281.25	Professional		$103.35	$162.44	$281.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.55 / $118.64 / $293.26	Professional		$78.55	$118.64	$293.26
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $1.92 / $1.92 / $2.90	Professional	AS	$1.92	$1.92	$2.90
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $180.18 / $280.56	Professional		$109.13	$180.18	$280.56