Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,677.67 / $1,677.67 / $3,985.16	Facility		$1,677.67	$1,677.67	$3,985.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,677.67 / $2,119.16 / $2,879.47	Professional		$1,677.67	$2,119.16	$2,879.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,532.74 / $4,945.84 / $12,965.16	Facility		$3,532.74	$4,945.84	$12,965.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,883.42 / $2,937.41 / $5,639.83	Professional		$1,883.42	$2,937.41	$5,639.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,002.83 / $3,294.93 / $6,535.57	Facility		$3,002.83	$3,294.93	$6,535.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,002.83 / $3,002.83 / $3,002.83	Professional		$3,002.83	$3,002.83	$3,002.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,507.59 / $2,507.59 / $2,507.59	Facility		$2,507.59	$2,507.59	$2,507.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,830.54 / $2,453.71 / $4,494.00	Professional		$1,830.54	$2,453.71	$4,494.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,684.88 / $3,532.74 / $5,193.03	Professional		$2,684.88	$3,532.74	$5,193.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.96 / $1,762.45 / $2,907.72	Professional		$1,174.96	$1,762.45	$2,907.72