Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $669.08 / $669.08 / $1,895.26	Facility		$669.08	$669.08	$1,895.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $669.08 / $857.10 / $1,070.52	Professional		$669.08	$857.10	$1,070.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,606.15 / $2,248.61 / $5,894.57	Facility		$1,606.15	$2,248.61	$5,894.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $844.92 / $1,293.81 / $2,862.53	Professional		$844.92	$1,293.81	$2,862.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,325.29 / $1,365.23 / $2,971.38	Facility		$1,325.29	$1,365.23	$2,971.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,365.23 / $1,365.23 / $1,365.23	Professional		$1,365.23	$1,365.23	$1,365.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.71 / $891.71 / $891.71	Facility		$891.71	$891.71	$891.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.95 / $650.95 / $1,694.96	Professional		$650.95	$650.95	$1,694.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,220.67 / $1,606.15 / $3,321.00	Professional		$1,220.67	$1,606.15	$3,321.00
United Facility/Professional Professional Modifier Low / Median / High Price $642.82 / $801.29 / $1,597.45	Professional		$642.82	$801.29	$1,597.45