Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $280.67 / $2,987.00 / $6,915.00	Facility		$280.67	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $201.80 / $238.62 / $343.21	Facility	54	$201.80	$238.62	$343.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.19 / $282.23 / $598.39	Professional		$231.19	$282.23	$598.39
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 $252.32 / $375.84 / $689.94	Professional		$252.32	$375.84	$689.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $459.32 / $565.42 / $769.14	Facility		$459.32	$565.42	$769.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $450.36 / $640.00	Facility		$177.38	$450.36	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $315.25 / $315.25 / $315.25	Facility	54	$315.25	$315.25	$315.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.79 / $391.73 / $686.77	Professional		$256.79	$391.73	$686.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $308.39 / $402.63 / $694.94	Professional		$308.39	$402.63	$694.94
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $372.60 / $372.60 / $389.17	Professional	54	$372.60	$372.60	$389.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $376.67 / $443.23 / $518.66	Professional		$376.67	$443.23	$518.66
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 $233.87 / $352.39 / $651.37	Professional		$233.87	$352.39	$651.37