Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,568.39 / $5,045.00 / $6,915.00	Facility		$1,568.39	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,477.88 / $1,758.39 / $3,267.91	Professional		$1,477.88	$1,758.39	$3,267.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $790.00 / $4,803.35 / $17,272.82	Facility		$790.00	$4,803.35	$17,272.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,565.36 / $2,595.90 / $4,458.99	Professional		$1,565.36	$2,595.90	$4,458.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,612.03 / $2,612.03 / $2,612.03	Facility		$2,612.03	$2,612.03	$2,612.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,473.73 / $1,473.73 / $1,473.73	Professional		$1,473.73	$1,473.73	$1,473.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,233.00	Facility		$200.00	$617.00	$1,233.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,607.74 / $2,548.02 / $3,863.40	Professional		$1,607.74	$2,548.02	$3,863.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,547.25 / $2,011.43 / $4,022.74	Professional		$1,547.25	$2,011.43	$4,022.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $2,889.70 / $3,887.60	Professional		$15.00	$2,889.70	$3,887.60
United Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $2,969.00 / $9,079.00	Facility		$400.00	$2,969.00	$9,079.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.59 / $2,202.00 / $3,740.79	Professional		$1,548.59	$2,202.00	$3,740.79