Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,638.86 / $3,660.83 / $5,349.12	Facility		$3,638.86	$3,660.83	$5,349.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,697.44 / $4,403.02	Professional		$3,660.83	$3,697.44	$4,403.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,660.83 / $5,959.83 / $13,435.25	Facility		$3,660.83	$5,959.83	$13,435.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,195.04 / $3,660.83 / $3,660.83	Professional		$3,195.04	$3,660.83	$3,660.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $7,175.23	Facility		$3,660.83	$3,660.83	$7,175.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,453.62 / $3,453.62 / $3,660.83	Facility		$3,453.62	$3,453.62	$3,660.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $3,660.83	Professional		$3,660.83	$3,660.83	$3,660.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,621.77 / $8,660.00 / $10,219.00	Professional		$2,621.77	$8,660.00	$10,219.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $4,239.77	Professional		$3,660.83	$3,660.83	$4,239.77