Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,085.30 / $1,085.30 / $3,074.24	Facility		$1,085.30	$1,085.30	$3,074.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,085.30 / $1,527.83 / $1,761.02	Professional		$1,085.30	$1,527.83	$1,761.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,605.29 / $3,647.41 / $9,561.41	Facility		$2,605.29	$3,647.41	$9,561.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,388.99 / $2,166.26 / $4,159.22	Professional		$1,388.99	$2,166.26	$4,159.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,021.79 / $2,574.34 / $4,819.79	Facility		$2,021.79	$2,574.34	$4,819.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,214.50 / $2,214.50 / $2,214.50	Professional		$2,214.50	$2,214.50	$2,214.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,486.28 / $1,486.28 / $1,486.28	Facility		$1,486.28	$1,486.28	$1,486.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,084.98 / $1,486.28 / $3,178.35	Professional		$1,084.98	$1,486.28	$3,178.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,980.02 / $2,605.29 / $3,619.61	Professional		$1,980.02	$2,605.29	$3,619.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,428.89 / $1,428.89 / $1,428.89	Facility		$1,428.89	$1,428.89	$1,428.89
United Facility/Professional Professional Modifier Low / Median / High Price $929.13 / $1,299.76 / $2,144.38	Professional		$929.13	$1,299.76	$2,144.38