Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $1,047.13	Facility		$354.81	$354.81	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $467.74 / $776.25	Professional		$354.81	$467.74	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $645.65 / $1,122.02	Professional		$537.03	$645.65	$1,122.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $2,089.30 / $3,162.28	Facility		$870.96	$2,089.30	$3,162.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $707.95 / $1,096.48	Professional		$489.78	$707.95	$1,096.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $1,445.44	Facility		$501.19	$501.19	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $1,047.13	Professional		$363.08	$363.08	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,174.90	Professional		$602.56	$870.96	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $602.56 / $630.96	Facility		$309.03	$602.56	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $831.76	Professional		$281.84	$426.58	$831.76