Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $285.30 / $3,826.00 / $6,915.00	Facility		$285.30	$3,826.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,475.00 / $4,353.00 / $9,727.04	Facility	50	$1,475.00	$4,353.00	$9,727.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.51 / $302.00 / $669.70	Professional		$180.51	$302.00	$669.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $509.51 / $1,040.28 / $1,496.37	Professional	50	$509.51	$1,040.28	$1,496.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $775.91 / $2,322.50 / $5,240.56	Facility		$775.91	$2,322.50	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.80 / $329.58 / $594.74	Professional		$208.80	$329.58	$594.74
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $313.25 / $494.38 / $892.11	Professional	50	$313.25	$494.38	$892.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $313.32 / $340.64 / $523.13	Facility		$313.32	$340.64	$523.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.62 / $1,000.62 / $1,000.62	Facility		$1,000.62	$1,000.62	$1,000.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.73 / $367.89 / $622.99	Professional		$217.73	$367.89	$622.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.54 / $277.38 / $794.11	Professional		$180.54	$277.38	$794.11
United Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $3,218.00 / $5,272.00	Facility		$607.00	$3,218.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $256.25 / $410.00 / $648.54	Professional		$256.25	$410.00	$648.54