Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $448.18 / $3,460.00 / $6,915.00	Facility		$448.18	$3,460.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $309.76 / $374.49 / $547.98	Facility	54	$309.76	$374.49	$547.98
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
CareSource Facility/Professional Facility Modifier Low / Median / High Price $707.42 / $862.65 / $1,173.47	Facility		$707.42	$862.65	$1,173.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.75 / $691.75 / $1,153.31	Facility		$691.75	$691.75	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $484.22 / $484.22 / $484.22	Facility	54	$484.22	$484.22	$484.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $470.96 / $624.36 / $1,105.49	Professional		$470.96	$624.36	$1,105.49
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $568.48 / $568.48 / $619.07	Professional	54	$568.48	$568.48	$619.07
United Facility/Professional Facility Modifier Low / Median / High Price $426.00 / $2,360.00 / $4,066.00	Facility		$426.00	$2,360.00	$4,066.00