Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $1,905.46	Facility		$645.65	$645.65	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $891.25 / $1,412.54	Professional		$645.65	$891.25	$1,412.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,715.35 / $5,754.40	Facility		$1,584.89	$3,715.35	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,288.25 / $2,089.30	Professional		$831.76	$1,288.25	$2,089.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Professional		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $2,754.23	Facility		$1,258.93	$1,258.93	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,905.46	Professional		$912.01	$912.01	$1,905.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,584.89 / $3,019.95	Professional		$1,096.48	$1,584.89	$3,019.95
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,148.15 / $1,230.27	Facility		$588.84	$1,148.15	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $776.25 / $1,513.56	Professional		$512.86	$776.25	$1,513.56