Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.20 / $2,800.00 / $6,915.00	Facility		$245.20	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $181.79 / $203.48 / $300.56	Facility	54	$181.79	$203.48	$300.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.12 / $249.50 / $463.78	Professional		$201.12	$249.50	$463.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $2,067.41 / $3,851.83	Facility		$635.46	$2,067.41	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.92 / $334.96 / $604.97	Professional		$220.92	$334.96	$604.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $417.84 / $491.57 / $698.75	Facility		$417.84	$491.57	$698.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $409.29 / $640.00	Facility		$177.38	$409.29	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $286.50	Facility	54	$286.50	$286.50	$286.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.27 / $329.23 / $608.14	Professional		$224.27	$329.23	$608.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.02 / $355.07 / $608.46	Professional		$270.02	$355.07	$608.46
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $338.50 / $338.50 / $340.74	Professional	54	$338.50	$338.50	$340.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $343.66 / $399.25 / $463.88	Professional		$343.66	$399.25	$463.88
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.31 / $307.77 / $608.36	Professional		$204.31	$307.77	$608.36