Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $600.45 / $600.45 / $1,700.84	Facility		$600.45	$600.45	$1,700.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.45 / $864.64 / $974.08	Professional		$600.45	$864.64	$974.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $858.80 / $1,066.63 / $1,066.63	Professional		$858.80	$1,066.63	$1,066.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,441.39 / $2,017.95 / $5,289.90	Facility		$1,441.39	$2,017.95	$5,289.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $768.45 / $1,198.49 / $2,301.10	Professional		$768.45	$1,198.49	$2,301.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,225.18 / $1,459.22 / $2,825.12	Facility		$1,225.18	$1,459.22	$2,825.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,225.18 / $1,225.18 / $1,225.18	Professional		$1,225.18	$1,225.18	$1,225.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,200.11 / $1,200.11 / $1,200.11	Facility		$1,200.11	$1,200.11	$1,200.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $1,086.67 / $1,963.89	Professional		$876.09	$1,086.67	$1,963.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,095.46 / $1,441.39 / $2,002.75	Professional		$1,095.46	$1,441.39	$2,002.75
United Facility/Professional Professional Modifier Low / Median / High Price $479.40 / $719.09 / $1,186.36	Professional		$479.40	$719.09	$1,186.36