Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $816.39 / $1,214.63 / $6,055.60	Facility		$816.39	$1,214.63	$6,055.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,739.00	Professional		$1,214.63	$1,214.63	$1,739.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,317.87 / $1,317.87	Facility		$1,214.63	$1,317.87	$1,317.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,384.68 / $1,384.68	Professional		$1,214.63	$1,384.68	$1,384.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,275.36 / $2,499.71	Facility		$1,238.93	$1,275.36	$2,499.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $972.58 / $2,713.00 / $2,783.00	Professional		$972.58	$2,713.00	$2,783.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,340.08	Professional		$1,214.63	$1,214.63	$1,340.08