Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $643.02 / $643.02 / $1,821.45	Facility		$643.02	$643.02	$1,821.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $643.02 / $913.08 / $1,096.90	Professional		$643.02	$913.08	$1,096.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,543.60 / $2,161.04 / $5,665.01	Facility		$1,543.60	$2,161.04	$5,665.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $822.94 / $1,283.47 / $2,464.26	Professional		$822.94	$1,283.47	$2,464.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,312.06 / $1,520.87 / $2,855.66	Facility		$1,312.06	$1,520.87	$2,855.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,312.06 / $1,312.06 / $1,312.06	Professional		$1,312.06	$1,312.06	$1,312.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.83 / $1,260.83 / $1,260.83	Facility		$1,260.83	$1,260.83	$1,260.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $920.41 / $920.41 / $2,062.73	Professional		$920.41	$920.41	$2,062.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,173.14 / $1,543.60 / $3,217.00	Professional		$1,173.14	$1,543.60	$3,217.00
United Facility/Professional Professional Modifier Low / Median / High Price $602.97 / $770.08 / $1,270.50	Professional		$602.97	$770.08	$1,270.50