Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $793.42 / $2,247.48	Facility		$793.42	$793.42	$2,247.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $793.42 / $1,126.66 / $1,598.36	Professional		$793.42	$1,126.66	$1,598.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,904.64 / $2,666.50 / $6,990.03	Facility		$1,904.64	$2,666.50	$6,990.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,152.52 / $1,583.67 / $3,040.65	Professional		$1,152.52	$1,583.67	$3,040.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,618.94 / $2,038.39 / $3,733.09	Facility		$1,618.94	$2,038.39	$3,733.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,618.94 / $1,618.94 / $1,618.94	Professional		$1,618.94	$1,618.94	$1,618.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,551.30 / $1,551.30 / $1,551.30	Facility		$1,551.30	$1,551.30	$1,551.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,132.45 / $1,132.45 / $2,544.83	Professional		$1,132.45	$1,132.45	$2,544.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,447.53 / $1,904.64 / $3,849.00	Professional		$1,447.53	$1,904.64	$3,849.00
United Facility/Professional Professional Modifier Low / Median / High Price $633.47 / $950.20 / $1,583.67	Professional		$633.47	$950.20	$1,583.67