Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.95 / $4,467.00 / $6,915.00	Facility		$293.95	$4,467.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $220.46 / $254.14 / $386.02	Facility	54	$220.46	$254.14	$386.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.60 / $319.27 / $651.96	Professional		$251.60	$319.27	$651.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.24 / $407.09 / $745.69	Professional		$284.24	$407.09	$745.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $502.49 / $618.74 / $841.67	Facility		$502.49	$618.74	$841.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $492.90 / $2,500.00	Facility		$177.38	$492.90	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $345.03 / $345.03 / $345.03	Facility	54	$345.03	$345.03	$345.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.51 / $432.86 / $758.50	Professional		$279.51	$432.86	$758.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.79 / $467.56 / $788.87	Professional		$337.79	$467.56	$788.87
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $407.75 / $407.75 / $441.77	Professional	54	$407.75	$407.75	$441.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $410.53 / $500.36 / $595.08	Professional		$410.53	$500.36	$595.08
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 $265.83 / $397.05 / $718.96	Professional		$265.83	$397.05	$718.96