Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $420.36 / $420.36 / $1,190.73	Facility		$420.36	$420.36	$1,190.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.36 / $596.91 / $765.41	Professional		$420.36	$596.91	$765.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,009.09 / $1,412.73 / $3,703.36	Facility		$1,009.09	$1,412.73	$3,703.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.98 / $839.04 / $1,610.96	Professional		$537.98	$839.04	$1,610.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $853.37 / $1,005.35 / $1,866.82	Facility		$853.37	$1,005.35	$1,866.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $857.73 / $857.73 / $857.73	Professional		$857.73	$857.73	$857.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.11 / $765.11 / $765.11	Facility		$765.11	$765.11	$765.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $558.53 / $558.53 / $1,341.41	Professional		$558.53	$558.53	$1,341.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $766.91 / $1,009.09 / $2,246.00	Professional		$766.91	$1,009.09	$2,246.00
United Facility/Professional Professional Modifier Low / Median / High Price $335.62 / $503.42 / $830.56	Professional		$335.62	$503.42	$830.56