Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $700.17 / $3,391.00 / $6,915.00	Facility		$700.17	$3,391.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.69 / $590.29 / $1,116.18	Professional		$305.69	$590.29	$1,116.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,403.52 / $1,403.52 / $1,403.52	Professional		$1,403.52	$1,403.52	$1,403.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,634.62 / $5,292.58	Facility		$964.00	$2,634.62	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $329.70 / $495.54 / $961.52	Professional		$329.70	$495.54	$961.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $693.61 / $693.61 / $693.61	Facility		$693.61	$693.61	$693.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $561.84 / $1,272.50 / $72,800.00	Facility		$561.84	$1,272.50	$72,800.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $56.18 / $56.18 / $56.18	Facility	AS	$56.18	$56.18	$56.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $385.91 / $705.91 / $1,516.33	Professional		$385.91	$705.91	$1,516.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.11 / $792.88 / $5,439.00	Professional		$393.11	$792.88	$5,439.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $15.16 / $15.16 / $30.57	Professional	AS	$15.16	$15.16	$30.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,323.00 / $4,581.00 / $6,995.00	Facility		$1,323.00	$4,581.00	$6,995.00
United Facility/Professional Professional Modifier Low / Median / High Price $551.67 / $849.35 / $1,670.77	Professional		$551.67	$849.35	$1,670.77