Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $529.89 / $532.58 / $782.89	Facility		$529.89	$532.58	$782.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $535.19 / $644.41	Professional		$529.89	$535.19	$644.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $529.89 / $862.66 / $1,944.70	Facility		$529.89	$862.66	$1,944.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $529.89 / $529.89	Professional		$529.89	$529.89	$529.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $529.89 / $529.89 / $1,038.58	Facility		$529.89	$529.89	$1,038.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $499.90 / $499.90 / $529.89	Facility		$499.90	$499.90	$529.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $529.89 / $529.89	Professional		$529.89	$529.89	$529.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $472.60 / $1,023.00 / $1,779.00	Professional		$472.60	$1,023.00	$1,779.00
United Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $529.89 / $613.79	Professional		$529.89	$529.89	$613.79