Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,357.48 / $5,045.00 / $6,915.00	Facility		$1,357.48	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,241.41 / $1,504.36 / $2,742.88	Professional		$1,241.41	$1,504.36	$2,742.88
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 $1,354.52 / $2,060.02 / $3,440.48	Professional		$1,354.52	$2,060.02	$3,440.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,926.42 / $1,926.42 / $1,926.42	Facility		$1,926.42	$1,926.42	$1,926.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,265.41 / $1,265.41 / $1,265.41	Professional		$1,265.41	$1,265.41	$1,265.41
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 $1,261.69 / $2,065.23 / $3,219.11	Professional		$1,261.69	$2,065.23	$3,219.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,343.98 / $1,747.17 / $3,111.03	Professional		$1,343.98	$1,747.17	$3,111.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.00 / $2,395.80 / $3,426.10	Professional		$7.00	$2,395.80	$3,426.10
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 $1,283.11 / $1,789.15 / $2,993.04	Professional		$1,283.11	$1,789.15	$2,993.04