Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $390.74 / $1,667.51 / $4,625.39	Facility		$390.74	$1,667.51	$4,625.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $390.74 / $392.06 / $472.80	Professional		$390.74	$392.06	$472.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $392.06 / $638.27 / $1,438.86	Facility		$392.06	$638.27	$1,438.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $313.64 / $392.06 / $392.06	Professional		$313.64	$392.06	$392.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $392.06 / $392.06 / $768.44	Facility		$392.06	$392.06	$768.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $369.87 / $369.87 / $392.06	Facility		$369.87	$369.87	$392.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $392.06 / $392.06	Professional		$392.06	$392.06	$392.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.96 / $108.96 / $421.20	Professional		$108.96	$108.96	$421.20
United Facility/Professional Professional Modifier Low / Median / High Price $392.06 / $392.06 / $415.81	Professional		$392.06	$392.06	$415.81