Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,041.74 / $3,715.35	Facility		$794.33	$2,041.74	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,479.11	Professional		$630.96	$794.33	$1,479.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $4,073.80 / $6,309.57	Facility		$1,698.24	$4,073.80	$6,309.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,137.96	Professional		$812.83	$1,380.38	$2,137.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $2,454.71	Facility		$831.76	$831.76	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $1,548.82	Professional		$616.60	$616.60	$1,548.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,698.24 / $2,344.23	Professional		$1,000.00	$1,698.24	$2,344.23
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $660.69 / $1,122.02	Facility		$416.87	$660.69	$1,122.02
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $794.33 / $1,548.82	Professional		$549.54	$794.33	$1,548.82