Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,549.96 / $1,549.96 / $4,390.50	Facility		$1,549.96	$1,549.96	$4,390.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,549.96 / $2,222.50 / $2,741.22	Professional		$1,549.96	$2,222.50	$2,741.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,720.76 / $5,209.06 / $13,655.19	Facility		$3,720.76	$5,209.06	$13,655.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,983.65 / $3,093.73 / $5,939.96	Professional		$1,983.65	$3,093.73	$5,939.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,145.38 / $3,649.30 / $6,883.41	Facility		$3,145.38	$3,649.30	$6,883.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,162.65 / $3,162.65 / $3,162.65	Professional		$3,162.65	$3,162.65	$3,162.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,717.61 / $2,717.61 / $2,717.61	Facility		$2,717.61	$2,717.61	$2,717.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,983.86 / $2,717.61 / $4,977.38	Professional		$1,983.86	$2,717.61	$4,977.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,827.78 / $3,720.76 / $6,723.44	Professional		$2,827.78	$3,720.76	$6,723.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,445.49 / $1,856.24 / $3,062.46	Professional		$1,445.49	$1,856.24	$3,062.46