Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,665.13 / $5,045.00 / $6,915.00	Facility		$1,665.13	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,463.33 / $1,751.10 / $3,733.06	Professional		$1,463.33	$1,751.10	$3,733.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,478.38 / $5,842.74 / $17,934.25	Facility		$1,478.38	$5,842.74	$17,934.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,580.78 / $2,298.83 / $4,107.50	Professional		$1,580.78	$2,298.83	$4,107.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,458.33 / $2,458.33 / $2,458.33	Facility		$2,458.33	$2,458.33	$2,458.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,815.11 / $2,500.00	Facility		$500.00	$1,815.11	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,674.40 / $2,622.68 / $4,129.47	Professional		$1,674.40	$2,622.68	$4,129.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,738.86 / $2,637.03 / $4,570.89	Professional		$1,738.86	$2,637.03	$4,570.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $7,794.00 / $14,048.00	Facility		$1,738.00	$7,794.00	$14,048.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,438.40 / $2,207.69 / $3,586.81	Professional		$1,438.40	$2,207.69	$3,586.81