Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $2,238.72	Facility		$758.58	$758.58	$2,238.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $933.25 / $1,548.82	Professional		$758.58	$933.25	$1,548.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $4,466.84 / $6,918.31	Facility		$1,862.09	$4,466.84	$6,918.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,513.56 / $2,344.23	Professional		$1,230.27	$1,513.56	$2,344.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $2,691.53	Facility		$1,023.29	$1,023.29	$2,691.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $2,137.96	Professional		$870.96	$870.96	$2,137.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,862.09 / $4,570.88	Professional		$1,230.27	$1,862.09	$4,570.88
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,230.27 / $1,288.25	Facility		$630.96	$1,230.27	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $912.01 / $1,778.28	Professional		$616.60	$912.01	$1,778.28