Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $364.75 / $2,595.00 / $6,915.00	Facility		$364.75	$2,595.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $243.23 / $273.56 / $436.56	Facility	54	$243.23	$273.56	$436.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.51 / $358.72 / $732.67	Professional		$288.51	$358.72	$732.67
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 $312.77 / $447.95 / $828.11	Professional		$312.77	$447.95	$828.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $553.42 / $681.32 / $926.79	Facility		$553.42	$681.32	$926.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $542.54 / $640.00	Facility		$177.38	$542.54	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $379.78 / $379.78 / $379.78	Facility	54	$379.78	$379.78	$379.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.70 / $474.70 / $833.82	Professional		$309.70	$474.70	$833.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.96 / $454.00 / $898.49	Professional		$371.96	$454.00	$898.49
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $448.99 / $448.99 / $503.15	Professional	54	$448.99	$448.99	$503.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $510.44 / $598.36 / $670.55	Professional		$510.44	$598.36	$670.55
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 $303.85 / $452.44 / $901.66	Professional		$303.85	$452.44	$901.66