Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $461.22 / $2,595.00 / $6,915.00	Facility		$461.22	$2,595.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $311.89 / $375.30 / $562.46	Facility	54	$311.89	$375.30	$562.46
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
CareSource Facility/Professional Facility Modifier Low / Median / High Price $715.13 / $873.24 / $1,187.86	Facility		$715.13	$873.24	$1,187.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $699.73 / $1,153.31	Facility		$640.00	$699.73	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $489.81 / $489.81 / $489.81	Facility	54	$489.81	$489.81	$489.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $476.74 / $636.58 / $1,140.34	Professional		$476.74	$636.58	$1,140.34
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $575.47 / $575.47 / $638.60	Professional	54	$575.47	$575.47	$638.60
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