Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,631.43 / $5,045.00 / $6,915.00	Facility		$1,631.43	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,499.79 / $1,813.47 / $3,325.94	Professional		$1,499.79	$1,813.47	$3,325.94
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 $1,630.99 / $2,497.07 / $4,173.83	Professional		$1,630.99	$2,497.07	$4,173.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,353.53 / $2,353.53 / $2,353.53	Facility		$2,353.53	$2,353.53	$2,353.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,528.09 / $1,528.09 / $1,528.09	Professional		$1,528.09	$1,528.09	$1,528.09
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 $1,527.07 / $2,517.44 / $4,095.46	Professional		$1,527.07	$2,517.44	$4,095.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,618.59 / $2,104.17 / $3,781.31	Professional		$1,618.59	$2,104.17	$3,781.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $2,853.50 / $4,105.20	Professional		$8.00	$2,853.50	$4,105.20
United Facility/Professional Facility Modifier Low / Median / High Price $485.00 / $2,907.00 / $8,133.00	Facility		$485.00	$2,907.00	$8,133.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,549.00 / $2,162.92 / $3,801.43	Professional		$1,549.00	$2,162.92	$3,801.43