Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $1,376.79 / $3,401.40	Facility		$1,323.35	$1,376.79	$3,401.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,665.92	Professional		$1,323.35	$1,323.35	$1,665.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $2,117.36 / $4,856.68	Facility		$1,323.35	$2,117.36	$4,856.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,349.81	Professional		$1,323.35	$1,323.35	$1,349.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $2,593.77	Facility		$1,323.35	$1,323.35	$2,593.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,323.35	Professional		$1,323.35	$1,323.35	$1,323.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,248.44 / $1,248.44 / $1,323.35	Facility		$1,248.44	$1,248.44	$1,323.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,685.39	Professional		$1,323.35	$1,323.35	$1,685.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,392.52 / $1,434.12 / $3,249.85	Professional		$1,392.52	$1,434.12	$3,249.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,303.33 / $2,015.60 / $2,817.77	Professional		$1,303.33	$2,015.60	$2,817.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,339.10 / $1,693.89	Professional		$1,323.35	$1,339.10	$1,693.89