Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.94 / $398.94 / $1,130.04	Facility		$398.94	$398.94	$1,130.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.94 / $566.49 / $671.63	Professional		$398.94	$566.49	$671.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $380.39 / $708.67 / $1,244.96	Professional		$380.39	$708.67	$1,244.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $957.66 / $1,340.72 / $3,514.61	Facility		$957.66	$1,340.72	$3,514.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $510.56 / $796.28 / $1,528.86	Professional		$510.56	$796.28	$1,528.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $814.01 / $999.63 / $1,877.01	Facility		$814.01	$999.63	$1,877.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $814.01 / $814.01 / $814.01	Professional		$814.01	$814.01	$814.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $694.09 / $694.09 / $694.09	Facility		$694.09	$694.09	$694.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.69 / $694.09 / $1,304.81	Professional		$506.69	$694.09	$1,304.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $727.82 / $957.66 / $1,330.56	Professional		$727.82	$957.66	$1,330.56
United Facility/Professional Professional Modifier Low / Median / High Price $318.51 / $477.77 / $796.28	Professional		$318.51	$477.77	$796.28