Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,176.55 / $2,176.55 / $6,165.38	Facility		$2,176.55	$2,176.55	$6,165.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,176.55 / $3,090.70 / $4,144.17	Professional		$2,176.55	$3,090.70	$4,144.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,224.89 / $7,314.86 / $19,175.38	Facility		$5,224.89	$7,314.86	$19,175.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,785.57 / $4,344.41 / $8,341.27	Professional		$2,785.57	$4,344.41	$8,341.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,441.17 / $4,921.34 / $9,666.07	Facility		$4,441.17	$4,921.34	$9,666.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4,441.17 / $4,441.17 / $4,441.17	Professional		$4,441.17	$4,441.17	$4,441.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,745.37 / $3,745.37 / $3,745.37	Facility		$3,745.37	$3,745.37	$3,745.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,734.12 / $2,734.12 / $6,967.81	Professional		$2,734.12	$2,734.12	$6,967.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,970.92 / $5,224.89 / $7,259.34	Professional		$3,970.92	$5,224.89	$7,259.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,737.76 / $2,606.65 / $4,300.52	Professional		$1,737.76	$2,606.65	$4,300.52