Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $571.08 / $571.08 / $1,617.67	Facility		$571.08	$571.08	$1,617.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $571.08 / $777.67 / $913.73	Professional		$571.08	$777.67	$913.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,370.91 / $1,919.27 / $5,031.24	Facility		$1,370.91	$1,919.27	$5,031.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $837.99 / $1,139.88 / $2,188.57	Professional		$837.99	$1,139.88	$2,188.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,100.59 / $1,170.31 / $2,536.17	Facility		$1,100.59	$1,170.31	$2,536.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,165.27 / $1,165.27 / $1,165.27	Professional		$1,165.27	$1,165.27	$1,165.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $809.08 / $809.08 / $809.08	Facility		$809.08	$809.08	$809.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $687.72 / $687.72 / $1,596.00	Professional		$687.72	$687.72	$1,596.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,041.89 / $1,370.91 / $4,259.00	Professional		$1,041.89	$1,370.91	$4,259.00
United Facility/Professional Professional Modifier Low / Median / High Price $455.95 / $683.93 / $1,128.36	Professional		$455.95	$683.93	$1,128.36