Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,189.20 / $1,189.20 / $3,368.58	Facility		$1,189.20	$1,189.20	$3,368.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,189.20 / $1,432.35 / $1,902.72	Professional		$1,189.20	$1,432.35	$1,902.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,854.73 / $3,996.62 / $10,476.86	Facility		$2,854.73	$3,996.62	$10,476.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,501.76 / $2,299.59 / $5,087.77	Professional		$1,501.76	$2,299.59	$5,087.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,355.55 / $2,426.52 / $5,281.25	Facility		$2,355.55	$2,426.52	$5,281.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,426.52 / $2,426.52 / $2,426.52	Professional		$2,426.52	$2,426.52	$2,426.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.92 / $1,584.92 / $1,584.92	Facility		$1,584.92	$1,584.92	$1,584.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,156.99 / $1,156.99 / $3,012.77	Professional		$1,156.99	$1,156.99	$3,012.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,169.59 / $2,854.73 / $6,294.00	Professional		$2,169.59	$2,854.73	$6,294.00
United Facility/Professional Professional Modifier Low / Median / High Price $990.80 / $1,424.19 / $2,467.15	Professional		$990.80	$1,424.19	$2,467.15