Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $3,801.89 / $7,413.10	Facility		$1,288.25	$3,801.89	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,778.28 / $4,570.88	Professional		$1,174.90	$1,778.28	$4,570.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,778.28 / $2,754.23	Professional		$1,000.00	$1,778.28	$2,754.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,818.38 / $6,025.60	Facility		$1,174.90	$2,818.38	$6,025.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,621.81 / $2,570.40	Professional		$1,288.25	$1,621.81	$2,570.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,479.11 / $1,621.81	Professional		$1,412.54	$1,479.11	$1,621.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,584.89 / $2,951.21	Professional		$1,148.15	$1,584.89	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,778.28 / $3,311.31	Professional		$1,584.89	$1,778.28	$3,311.31
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional	22	$3,019.95	$3,019.95	$3,019.95
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $933.25 / $933.25 / $933.25	Professional	62	$933.25	$933.25	$933.25
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	80	$79.43	$79.43	$79.43
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	AS	$39.81	$39.81	$39.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $5,754.40 / $8,511.38	Facility		$1,513.56	$5,754.40	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,905.46 / $3,311.31	Professional		$1,348.96	$1,905.46	$3,311.31