Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $6,626.17 / $24,754.17	Facility		$1,730.32	$6,626.17	$24,754.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,747.63 / $2,345.08	Professional		$1,730.32	$1,747.63	$2,345.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $2,816.96 / $6,350.27	Facility		$1,730.32	$2,816.96	$6,350.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,384.25 / $1,730.32 / $1,730.32	Professional		$1,384.25	$1,730.32	$1,730.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $3,391.43	Facility		$1,730.32	$1,730.32	$3,391.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,632.38 / $1,632.38 / $1,730.32	Facility		$1,632.38	$1,632.38	$1,730.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $1,730.32	Professional		$1,730.32	$1,730.32	$1,730.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $783.44 / $783.44 / $1,833.46	Professional		$783.44	$783.44	$1,833.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,770.52 / $4,593.33 / $4,593.33	Facility		$1,770.52	$4,593.33	$4,593.33
United Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,834.14 / $2,154.50	Professional		$1,730.32	$1,834.14	$2,154.50