Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $397.72 / $397.72 / $1,126.59	Facility		$397.72	$397.72	$1,126.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $397.72 / $564.76 / $636.35	Professional		$397.72	$564.76	$636.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $493.00 / $706.52 / $1,241.18	Professional		$493.00	$706.52	$1,241.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.75 / $1,336.65 / $3,503.93	Facility		$954.75	$1,336.65	$3,503.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $509.00 / $793.85 / $1,524.19	Professional		$509.00	$793.85	$1,524.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $811.54 / $954.75 / $1,871.31	Facility		$811.54	$954.75	$1,871.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $811.54 / $811.54 / $811.54	Professional		$811.54	$811.54	$811.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $596.58 / $596.58 / $596.58	Facility		$596.58	$596.58	$596.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $435.50 / $435.50 / $1,275.55	Professional		$435.50	$435.50	$1,275.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $725.61 / $954.75 / $1,326.07	Professional		$725.61	$954.75	$1,326.07
United Facility/Professional Facility Modifier Low / Median / High Price $293.58 / $629.41 / $717.65	Facility		$293.58	$629.41	$717.65
United Facility/Professional Professional Modifier Low / Median / High Price $317.54 / $476.31 / $932.37	Professional		$317.54	$476.31	$932.37