Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $651.77 / $651.77 / $1,548.21	Facility		$651.77	$651.77	$1,548.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $637.07 / $823.28 / $1,090.29	Professional		$637.07	$823.28	$1,090.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,372.45 / $1,921.43 / $5,036.89	Facility		$1,372.45	$1,921.43	$5,036.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $779.48 / $1,141.17 / $2,191.05	Professional		$779.48	$1,141.17	$2,191.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,166.58 / $1,318.51 / $2,539.03	Facility		$1,166.58	$1,318.51	$2,539.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,166.58 / $1,166.58 / $1,166.58	Professional		$1,166.58	$1,166.58	$1,166.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $969.19 / $969.19 / $969.19	Facility		$969.19	$969.19	$969.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.51 / $707.51 / $1,869.96	Professional		$707.51	$707.51	$1,869.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,043.06 / $1,372.45 / $2,611.53	Professional		$1,043.06	$1,372.45	$2,611.53
United Facility/Professional Professional Modifier Low / Median / High Price $456.47 / $684.70 / $1,129.63	Professional		$456.47	$684.70	$1,129.63