Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.48 / $2,800.00 / $6,915.00	Facility		$375.48	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $258.66 / $303.33 / $453.85	Facility	54	$258.66	$303.33	$453.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.66 / $375.48 / $706.70	Professional		$302.66	$375.48	$706.70
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 $328.90 / $477.36 / $878.46	Professional		$328.90	$477.36	$878.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $589.89 / $724.71 / $985.82	Facility		$589.89	$724.71	$985.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $578.13 / $640.00	Facility		$177.38	$578.13	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $404.69	Facility	54	$404.69	$404.69	$404.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.33 / $507.15 / $891.94	Professional		$327.33	$507.15	$891.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $395.66 / $549.54 / $925.58	Professional		$395.66	$549.54	$925.58
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $477.58 / $477.58 / $518.32	Professional	54	$477.58	$477.58	$518.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $544.09 / $619.83 / $690.77	Professional		$544.09	$619.83	$690.77
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 $311.20 / $466.82 / $846.77	Professional		$311.20	$466.82	$846.77