Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $469.42 / $469.42 / $1,329.68	Facility		$469.42	$469.42	$1,329.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $469.42 / $666.57 / $773.92	Professional		$469.42	$666.57	$773.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,126.84 / $1,577.59 / $4,135.54	Facility		$1,126.84	$1,577.59	$4,135.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $600.76 / $936.96 / $1,798.96	Professional		$600.76	$936.96	$1,798.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $957.82 / $1,147.59 / $2,084.67	Facility		$957.82	$1,147.59	$2,084.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $957.82 / $957.82 / $957.82	Professional		$957.82	$957.82	$957.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $957.73 / $957.73 / $957.73	Facility		$957.73	$957.73	$957.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $699.14 / $854.62 / $1,461.48	Professional		$699.14	$854.62	$1,461.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $856.41 / $1,126.84 / $1,565.77	Professional		$856.41	$1,126.84	$1,565.77
United Facility/Professional Facility Modifier Low / Median / High Price $595.23 / $595.23 / $595.23	Facility		$595.23	$595.23	$595.23
United Facility/Professional Professional Modifier Low / Median / High Price $374.78 / $562.17 / $1,100.44	Professional		$374.78	$562.17	$1,100.44