Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $312.30 / $4,200.00 / $6,915.00	Facility		$312.30	$4,200.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,366.31 / $3,366.31 / $3,366.31	Facility	50	$3,366.31	$3,366.31	$3,366.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.77 / $283.06 / $574.05	Professional		$150.77	$283.06	$574.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $929.00 / $971.24 / $1,021.29	Professional	50	$929.00	$971.24	$1,021.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $996.37 / $2,722.51 / $5,292.58	Facility		$996.37	$2,722.51	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.21 / $292.33 / $481.95	Professional		$180.21	$292.33	$481.95
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $270.32 / $438.51 / $722.93	Professional	50	$270.32	$438.51	$722.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $278.45 / $302.73 / $464.91	Facility		$278.45	$302.73	$464.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $236.17 / $236.17 / $236.17	Facility		$236.17	$236.17	$236.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.04 / $334.52 / $652.95	Professional		$187.04	$334.52	$652.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.46 / $305.55 / $2,851.00	Professional		$160.46	$305.55	$2,851.00
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 $270.61 / $386.64 / $671.56	Professional		$270.61	$386.64	$671.56