Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $543.69 / $543.69 / $1,540.09	Facility		$543.69	$543.69	$1,540.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.69 / $654.87 / $869.90	Professional		$543.69	$654.87	$869.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $965.82 / $965.82 / $978.87	Professional		$965.82	$965.82	$978.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,305.16 / $1,827.22 / $4,789.93	Facility		$1,305.16	$1,827.22	$4,789.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $695.81 / $1,085.21 / $2,083.60	Professional		$695.81	$1,085.21	$2,083.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,076.98 / $1,109.39 / $2,414.55	Facility		$1,076.98	$1,109.39	$2,414.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,109.39 / $1,109.39 / $1,109.39	Professional		$1,109.39	$1,109.39	$1,109.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.63 / $724.63 / $724.63	Facility		$724.63	$724.63	$724.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.98 / $724.63 / $1,504.88	Professional		$528.98	$724.63	$1,504.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $991.92 / $1,305.16 / $1,813.28	Professional		$991.92	$1,305.16	$1,813.28
United Facility/Professional Professional Modifier Low / Median / High Price $453.00 / $651.13 / $1,074.24	Professional		$453.00	$651.13	$1,074.24