Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.73 / $3,295.00 / $6,915.00	Facility		$489.73	$3,295.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $333.01 / $427.57 / $597.71	Facility	54	$333.01	$427.57	$597.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.97 / $489.73 / $1,023.15	Professional		$394.97	$489.73	$1,023.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $869.00 / $2,354.21 / $5,240.56	Facility		$869.00	$2,354.21	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $431.83 / $618.54 / $1,132.91	Professional		$431.83	$618.54	$1,132.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $752.96 / $885.83 / $1,247.55	Facility		$752.96	$885.83	$1,247.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.07 / $736.07 / $1,153.31	Facility		$736.07	$736.07	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $515.25 / $515.25 / $515.25	Facility	54	$515.25	$515.25	$515.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.02 / $667.87 / $1,150.96	Professional		$455.02	$667.87	$1,150.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $500.70 / $671.40 / $1,188.77	Professional		$500.70	$671.40	$1,188.77
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $604.38 / $604.38 / $665.71	Professional	54	$604.38	$604.38	$665.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $631.32 / $743.08 / $887.20	Professional		$631.32	$743.08	$887.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $4,826.00 / $7,889.00	Facility		$1,075.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $409.86 / $635.35 / $1,089.60	Professional		$409.86	$635.35	$1,089.60