Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.76 / $5,045.00 / $6,915.00	Facility		$1,202.76	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,103.98 / $1,334.76 / $2,438.29	Professional		$1,103.98	$1,334.76	$2,438.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,801.18 / $10,304.31	Facility		$659.95	$3,801.18	$10,304.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,201.38 / $1,833.35 / $3,063.90	Professional		$1,201.38	$1,833.35	$3,063.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,717.51 / $1,717.51 / $1,717.51	Facility		$1,717.51	$1,717.51	$1,717.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,129.02 / $1,129.02 / $1,129.02	Professional		$1,129.02	$1,129.02	$1,129.02
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 $1,110.19 / $1,867.84 / $2,869.86	Professional		$1,110.19	$1,867.84	$2,869.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,198.17 / $1,557.62 / $2,785.54	Professional		$1,198.17	$1,557.62	$2,785.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.00 / $2,119.60 / $3,037.80	Professional		$7.00	$2,119.60	$3,037.80
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 $1,139.08 / $1,573.56 / $2,666.33	Professional		$1,139.08	$1,573.56	$2,666.33