Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,543.89 / $2,608.16 / $5,366.50	Facility		$2,543.89	$2,608.16	$5,366.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,543.89 / $2,608.16 / $3,078.11	Professional		$2,543.89	$2,608.16	$3,078.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,608.16 / $4,173.06 / $9,571.95	Facility		$2,608.16	$4,173.06	$9,571.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $2,660.32	Professional		$2,608.16	$2,608.16	$2,660.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $5,111.99	Facility		$2,608.16	$2,608.16	$5,111.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $2,608.16	Professional		$2,608.16	$2,608.16	$2,608.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,460.53 / $2,460.53 / $2,608.16	Facility		$2,460.53	$2,460.53	$2,608.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $3,321.71	Professional		$2,608.16	$2,608.16	$3,321.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,109.35 / $2,732.53 / $4,617.37	Professional		$2,109.35	$2,732.53	$4,617.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,077.50 / $3,501.19 / $5,233.41	Professional		$2,077.50	$3,501.19	$5,233.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,673.43 / $5,213.18 / $5,213.18	Facility		$2,673.43	$5,213.18	$5,213.18
United Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,750.30 / $3,338.44	Professional		$2,608.16	$2,750.30	$3,338.44