Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $439.15 / $4,908.00 / $6,915.00	Facility		$439.15	$4,908.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,842.50 / $3,534.00 / $5,301.00	Facility	50	$2,842.50	$3,534.00	$5,301.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.60 / $1,534.38 / $3,720.01	Professional		$166.60	$1,534.38	$3,720.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,723.84 / $2,832.90 / $5,360.46	Professional	50	$1,723.84	$2,832.90	$5,360.46
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $4,230.96 / $4,230.96 / $4,230.96	Professional	50	$4,230.96	$4,230.96	$4,230.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,860.62 / $5,304.99 / $10,832.53	Facility		$1,860.62	$5,304.99	$10,832.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.36 / $1,337.17 / $3,775.11	Professional		$205.36	$1,337.17	$3,775.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $309.01 / $2,005.76 / $5,662.66	Professional	50	$309.01	$2,005.76	$5,662.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $295.47 / $322.35 / $495.05	Facility		$295.47	$322.35	$495.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,883.88 / $3,883.88 / $3,883.88	Facility		$3,883.88	$3,883.88	$3,883.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.25 / $1,680.35 / $4,319.27	Professional		$219.25	$1,680.35	$4,319.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.26 / $1,671.18 / $10,261.00	Professional		$170.26	$1,671.18	$10,261.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $9.89 / $9.89 / $97.08	Professional	80	$9.89	$9.89	$97.08
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $4.94 / $4.94 / $48.54	Professional	AS	$4.94	$4.94	$48.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,351.00 / $8,836.00	Facility		$1,519.00	$6,351.00	$8,836.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,928.54 / $2,989.24 / $4,042.11	Professional		$1,928.54	$2,989.24	$4,042.11