Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,167.83 / $5,045.00 / $6,915.00	Facility		$1,167.83	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,063.58 / $1,291.79 / $2,355.90	Professional		$1,063.58	$1,291.79	$2,355.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.00 / $2,580.19 / $6,160.12	Facility		$635.00	$2,580.19	$6,160.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,157.06 / $1,705.20 / $2,957.66	Professional		$1,157.06	$1,705.20	$2,957.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,621.48 / $1,621.48 / $1,621.48	Facility		$1,621.48	$1,621.48	$1,621.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,087.47 / $1,087.47 / $1,087.47	Professional		$1,087.47	$1,087.47	$1,087.47
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 $999.79 / $1,772.88 / $2,771.40	Professional		$999.79	$1,772.88	$2,771.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,157.06 / $1,504.18 / $2,636.40	Professional		$1,157.06	$1,504.18	$2,636.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.00 / $2,049.69 / $2,954.00	Professional		$7.00	$2,049.69	$2,954.00
United Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $2,307.00 / $5,272.00	Facility		$515.00	$2,307.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,062.21 / $1,470.30 / $2,661.44	Professional		$1,062.21	$1,470.30	$2,661.44