Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.15 / $4,592.00 / $6,915.00	Facility		$336.15	$4,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,781.00 / $1,781.00 / $5,301.00	Facility	50	$1,781.00	$1,781.00	$5,301.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.91 / $1,559.00 / $4,367.72	Professional		$191.91	$1,559.00	$4,367.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $5,250.90 / $5,441.93 / $5,742.09	Professional	50	$5,250.90	$5,441.93	$5,742.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,434.33 / $1,434.33 / $1,434.33	Professional		$1,434.33	$1,434.33	$1,434.33
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 $235.21 / $1,357.71 / $5,296.40	Professional		$235.21	$1,357.71	$5,296.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $352.81 / $2,036.57 / $7,944.60	Professional	50	$352.81	$2,036.57	$7,944.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $337.44 / $368.49 / $565.89	Facility		$337.44	$368.49	$565.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,808.86 / $1,808.86 / $1,808.86	Facility		$1,808.86	$1,808.86	$1,808.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.77 / $1,702.55 / $4,871.91	Professional		$248.77	$1,702.55	$4,871.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.44 / $1,699.62 / $10,334.00	Professional		$194.44	$1,699.62	$10,334.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $5.65 / $5.65 / $49.37	Professional	AS	$5.65	$5.65	$49.37
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 $1,954.86 / $3,360.46 / $5,935.50	Professional		$1,954.86	$3,360.46	$5,935.50