Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,493.75 / $6,661.13 / $11,887.50	Facility		$2,493.75	$6,661.13	$11,887.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,493.75 / $3,262.50 / $4,189.50	Professional		$2,493.75	$3,262.50	$4,189.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,442.14 / $4,143.75 / $12,975.00	Facility		$2,442.14	$4,143.75	$12,975.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,200.00 / $1,500.00 / $4,650.00	Professional		$1,200.00	$1,500.00	$4,650.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,750.00 / $5,437.50 / $8,059.86	Facility		$3,750.00	$5,437.50	$8,059.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,898.20 / $6,093.75 / $11,562.99	Facility		$1,898.20	$6,093.75	$11,562.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,685.57 / $4,292.25 / $14,518.48	Professional		$1,685.57	$4,292.25	$14,518.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,375.00 / $4,875.00 / $29,228.61	Professional		$3,375.00	$4,875.00	$29,228.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4,537.50 / $5,250.00 / $6,937.50	Professional		$4,537.50	$5,250.00	$6,937.50
United Facility/Professional Facility Modifier Low / Median / High Price $3,375.00 / $3,375.00 / $3,375.00	Facility		$3,375.00	$3,375.00	$3,375.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,460.15 / $1,875.00 / $6,564.38	Professional		$1,460.15	$1,875.00	$6,564.38