Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $742.90 / $748.85 / $1,092.06	Facility		$742.90	$748.85	$1,092.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $756.33 / $898.91	Professional		$748.85	$756.33	$898.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $748.85 / $1,219.13 / $2,748.28	Facility		$748.85	$1,219.13	$2,748.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $599.08 / $748.85 / $748.85	Professional		$599.08	$748.85	$748.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $748.85 / $748.85 / $1,467.75	Facility		$748.85	$748.85	$1,467.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $706.46 / $706.46 / $748.84	Facility		$706.46	$706.46	$748.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Professional		$748.84	$748.84	$748.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $102.44 / $786.93	Professional		$102.44	$102.44	$786.93
United Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $805.10	Professional		$748.85	$748.85	$805.10