Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $1,479.11	Facility		$575.44	$575.44	$1,479.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $691.83 / $1,096.48	Professional		$575.44	$691.83	$1,096.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,884.03 / $4,466.84	Facility		$1,230.27	$2,884.03	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,000.00 / $1,621.81	Professional		$645.65	$1,000.00	$1,621.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $2,187.76	Facility		$758.58	$758.58	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $1,479.11	Professional		$549.54	$549.54	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,230.27 / $1,819.70	Professional		$851.14	$1,230.27	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $588.84 / $812.83	Facility		$380.19	$588.84	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $602.56 / $1,174.90	Professional		$398.11	$602.56	$1,174.90