Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,271.04 / $1,271.04 / $3,600.40	Facility		$1,271.04	$1,271.04	$3,600.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,271.04 / $1,374.42 / $2,033.66	Professional		$1,271.04	$1,374.42	$2,033.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,051.19 / $4,271.67 / $11,197.87	Facility		$3,051.19	$4,271.67	$11,197.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,398.04 / $2,537.01 / $4,871.06	Professional		$1,398.04	$2,537.01	$4,871.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,947.78 / $2,593.51 / $5,644.70	Facility		$1,947.78	$2,593.51	$5,644.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,593.51 / $2,593.51 / $2,593.51	Professional		$2,593.51	$2,593.51	$2,593.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,665.63 / $1,665.63 / $1,665.63	Facility		$1,665.63	$1,665.63	$1,665.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,215.91 / $1,629.83 / $2,985.00	Professional		$1,215.91	$1,629.83	$2,985.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,318.90 / $3,051.19 / $4,282.50	Professional		$2,318.90	$3,051.19	$4,282.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,983.27 / $3,772.27 / $5,644.70	Professional		$1,983.27	$3,772.27	$5,644.70
United Facility/Professional Professional Modifier Low / Median / High Price $1,014.80 / $1,522.21 / $2,537.01	Professional		$1,014.80	$1,522.21	$2,537.01