Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.65 / $542.65 / $1,289.02	Facility		$542.65	$542.65	$1,289.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $542.65 / $685.45 / $1,028.19	Professional		$542.65	$685.45	$1,028.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,142.69 / $1,599.77 / $4,193.67	Facility		$1,142.69	$1,599.77	$4,193.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $609.21 / $950.12 / $1,824.23	Professional		$609.21	$950.12	$1,824.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $971.29 / $1,145.67 / $2,113.98	Facility		$971.29	$1,145.67	$2,113.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $971.29 / $971.29 / $971.29	Professional		$971.29	$971.29	$971.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.02 / $714.02 / $714.02	Facility		$714.02	$714.02	$714.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $521.23 / $714.01 / $1,526.90	Professional		$521.23	$714.01	$1,526.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $868.44 / $1,142.69 / $1,725.51	Professional		$868.44	$1,142.69	$1,725.51
United Facility/Professional Professional Modifier Low / Median / High Price $380.05 / $570.07 / $940.52	Professional		$380.05	$570.07	$940.52