Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $5,811.99	Facility		$2,698.05	$2,698.05	$5,811.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,264.64	Professional		$2,698.05	$2,698.05	$3,264.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $4,316.88 / $9,901.84	Facility		$2,698.05	$4,316.88	$9,901.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $2,752.01	Professional		$2,698.05	$2,698.05	$2,752.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $5,288.18	Facility		$2,698.05	$2,698.05	$5,288.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $2,698.05	Professional		$2,698.05	$2,698.05	$2,698.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,545.33 / $2,545.33 / $2,698.05	Facility		$2,545.33	$2,545.33	$2,698.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,188.79	Professional		$2,698.05	$2,698.05	$3,188.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,182.91 / $3,056.85 / $7,808.00	Professional		$2,182.91	$3,056.85	$7,808.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,563.15 / $4,586.68 / $5,557.73	Professional		$2,563.15	$4,586.68	$5,557.73
United Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,859.93 / $3,372.56	Professional		$2,698.05	$2,859.93	$3,372.56