Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.65 / $1,571.00 / $5,063.00	Facility		$150.65	$1,571.00	$5,063.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $445.16 / $993.60 / $1,571.00	Facility	50	$445.16	$993.60	$1,571.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.14 / $141.10 / $333.24	Professional		$61.14	$141.10	$333.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $278.00 / $495.50 / $1,251.44	Professional	50	$278.00	$495.50	$1,251.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,080.80 / $3,851.83	Facility		$734.14	$2,080.80	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $84.63 / $155.61	Professional		$58.60	$84.63	$155.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $87.90 / $126.94 / $233.41	Professional	50	$87.90	$126.94	$233.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.61 / $78.06 / $124.35	Facility		$64.61	$78.06	$124.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $183.94 / $185.03 / $319.64	Professional		$183.94	$185.03	$319.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $143.38 / $343.72	Professional		$76.00	$143.38	$343.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.91 / $151.47 / $212.06	Professional		$60.91	$151.47	$212.06
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.80 / $174.88 / $366.21	Professional		$105.80	$174.88	$366.21