Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $597.29 / $597.29 / $1,418.84	Facility		$597.29	$597.29	$1,418.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $597.29 / $754.48 / $997.44	Professional		$597.29	$754.48	$997.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,257.76 / $1,760.86 / $4,615.97	Facility		$1,257.76	$1,760.86	$4,615.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $690.23 / $1,045.80 / $2,007.94	Professional		$690.23	$1,045.80	$2,007.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,027.56 / $1,277.07 / $2,326.86	Facility		$1,027.56	$1,277.07	$2,326.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,069.09 / $1,069.09 / $1,069.09	Professional		$1,069.09	$1,069.09	$1,069.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $755.39 / $755.39 / $755.39	Facility		$755.39	$755.39	$755.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $551.42 / $755.38 / $1,615.16	Professional		$551.42	$755.38	$1,615.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $955.90 / $1,257.76 / $1,825.48	Professional		$955.90	$1,257.76	$1,825.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,319.26 / $1,632.47 / $2,681.86	Professional		$1,319.26	$1,632.47	$2,681.86
United Facility/Professional Professional Modifier Low / Median / High Price $418.32 / $627.48 / $1,035.23	Professional		$418.32	$627.48	$1,035.23