Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,237.28	Facility		$1,237.28	$1,237.28	$1,237.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,299.15	Professional		$1,237.28	$1,237.28	$1,299.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,262.02	Professional		$1,237.28	$1,237.28	$1,262.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $2,425.07	Facility		$1,237.28	$1,237.28	$2,425.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,167.25 / $1,167.25 / $1,237.28	Facility		$1,167.25	$1,167.25	$1,237.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,575.79	Professional		$1,237.28	$1,237.28	$1,575.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,159.60 / $1,159.60 / $2,526.00	Professional		$1,159.60	$1,159.60	$2,526.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $192.97 / $239.19 / $2,288.98	Professional		$192.97	$239.19	$2,288.98
United Facility/Professional Professional Modifier Low / Median / High Price $1,175.42 / $1,237.28 / $1,679.60	Professional		$1,175.42	$1,237.28	$1,679.60