Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $680.62 / $680.62 / $1,927.93	Facility		$680.62	$680.62	$1,927.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $680.62 / $966.47 / $1,088.98	Professional		$680.62	$966.47	$1,088.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,633.84 / $2,287.38 / $5,996.19	Facility		$1,633.84	$2,287.38	$5,996.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $871.05 / $1,358.51 / $2,608.34	Professional		$871.05	$1,358.51	$2,608.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,385.60 / $1,507.55 / $3,022.60	Facility		$1,385.60	$1,507.55	$3,022.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,388.76 / $1,388.76 / $1,388.76	Professional		$1,388.76	$1,388.76	$1,388.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,018.60 / $1,018.60 / $1,018.60	Facility		$1,018.60	$1,018.60	$1,018.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $743.58 / $743.58 / $2,226.11	Professional		$743.58	$743.58	$2,226.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,241.72 / $1,633.84 / $2,270.19	Professional		$1,241.72	$1,633.84	$2,270.19
United Facility/Professional Professional Modifier Low / Median / High Price $543.40 / $815.11 / $1,344.78	Professional		$543.40	$815.11	$1,344.78