Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $776.25 / $1,548.82	Facility		$691.83	$776.25	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $831.76	Professional		$691.83	$691.83	$831.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,122.02 / $3,801.89	Facility		$691.83	$1,122.02	$3,801.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $691.83	Facility		$645.65	$645.65	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $776.25	Professional		$691.83	$691.83	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $794.33 / $1,380.38	Professional		$691.83	$794.33	$1,380.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $691.83 / $1,230.27	Professional		$30.20	$691.83	$1,230.27
United Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,258.93 / $1,778.28	Facility		$645.65	$1,258.93	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $691.83 / $831.76	Professional		$645.65	$691.83	$831.76