Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $522.65 / $3,018.00 / $6,915.00	Facility		$522.65	$3,018.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $351.63 / $453.58 / $637.16	Facility	54	$351.63	$453.58	$637.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.35 / $517.71 / $1,033.57	Professional		$413.35	$517.71	$1,033.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,322.50 / $5,240.56	Facility		$741.08	$2,322.50	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.55 / $652.86 / $1,198.92	Professional		$460.55	$652.86	$1,198.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $796.79 / $970.13 / $1,319.66	Facility		$796.79	$970.13	$1,319.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $778.84 / $1,153.31	Facility		$640.00	$778.84	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $545.19 / $545.19 / $545.19	Facility	54	$545.19	$545.19	$545.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $473.68 / $709.70 / $1,234.57	Professional		$473.68	$709.70	$1,234.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $529.63 / $759.99 / $1,275.09	Professional		$529.63	$759.99	$1,275.09
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $639.29 / $639.29 / $714.06	Professional	54	$639.29	$639.29	$714.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $734.91 / $852.02 / $951.64	Professional		$734.91	$852.02	$951.64
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 $439.89 / $680.11 / $1,170.10	Professional		$439.89	$680.11	$1,170.10