Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.76 / $2,555.00 / $6,900.00	Facility		$588.76	$2,555.00	$6,900.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $317.12 / $381.90 / $538.04	Facility	54	$317.12	$381.90	$538.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,292.94 / $5,240.56	Facility		$741.08	$2,292.94	$5,240.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $715.25 / $842.60 / $1,185.77	Facility		$715.25	$842.60	$1,185.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $472.05 / $472.05 / $1,153.31	Facility		$472.05	$472.05	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $328.83 / $328.83 / $328.83	Facility	54	$328.83	$328.83	$328.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $455.20 / $628.54 / $1,025.78	Professional		$455.20	$628.54	$1,025.78
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $574.44 / $574.44 / $574.44	Professional	54	$574.44	$574.44	$574.44
United Facility/Professional Facility Modifier Low / Median / High Price $625.00 / $3,218.00 / $5,272.00	Facility		$625.00	$3,218.00	$5,272.00