Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $712.72 / $4,817.00 / $6,915.00	Facility		$712.72	$4,817.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,082.75 / $4,518.00 / $6,777.00	Facility	50	$2,082.75	$4,518.00	$6,777.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.00 / $2,883.06 / $6,389.00	Professional		$253.00	$2,883.06	$6,389.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $9,722.78 / $10,091.69 / $10,745.84	Professional	50	$9,722.78	$10,091.69	$10,745.84
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 $319.39 / $1,136.45 / $6,508.57	Professional		$319.39	$1,136.45	$6,508.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $487.25 / $1,704.67 / $9,762.85	Professional	50	$487.25	$1,704.67	$9,762.85
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $45.47 / $159.10 / $911.19	Professional	AS	$45.47	$159.10	$911.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $476.36 / $520.97 / $800.06	Facility		$476.36	$520.97	$800.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,928.03 / $3,928.03 / $3,928.03	Facility		$3,928.03	$3,928.03	$3,928.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.11 / $3,861.01 / $7,427.30	Professional		$318.11	$3,861.01	$7,427.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $274.48 / $3,136.91 / $19,978.00	Professional		$274.48	$3,136.91	$19,978.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $7.97 / $7.97 / $91.11	Professional	AS	$7.97	$7.97	$91.11
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 $3,678.02 / $5,259.57 / $7,640.90	Professional		$3,678.02	$5,259.57	$7,640.90