Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $528.58 / $636.59 / $1,152.30	Facility		$528.58	$636.59	$1,152.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $642.96 / $1,510.59	Professional		$636.59	$642.96	$1,510.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $636.59 / $1,036.36 / $2,336.29	Facility		$636.59	$1,036.36	$2,336.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $649.32	Professional		$636.59	$636.59	$649.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $636.59 / $636.59 / $1,252.11	Facility		$636.59	$636.59	$1,252.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $600.55 / $600.55 / $636.59	Facility		$600.55	$600.55	$636.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $636.59	Professional		$636.59	$636.59	$636.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $621.12 / $1,681.00 / $2,678.00	Professional		$621.12	$1,681.00	$2,678.00
United Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $973.98	Professional		$636.59	$636.59	$973.98