Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.49 / $1,482.00 / $6,726.00	Facility		$284.49	$1,482.00	$6,726.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $201.50 / $221.29 / $359.65	Facility	54	$201.50	$221.29	$359.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.69 / $295.05 / $651.38	Professional		$236.69	$295.05	$651.38
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 $259.87 / $371.98 / $678.94	Professional		$259.87	$371.98	$678.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $391.34 / $391.34 / $391.34	Facility		$391.34	$391.34	$391.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $460.77 / $2,500.00	Facility		$177.38	$460.77	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $322.54 / $322.54 / $322.54	Facility	54	$322.54	$322.54	$322.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.50 / $393.00 / $701.31	Professional		$254.50	$393.00	$701.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $313.47 / $383.00 / $742.04	Professional		$313.47	$383.00	$742.04
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $378.39 / $378.39 / $415.54	Professional	54	$378.39	$378.39	$415.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $370.66 / $466.98 / $538.83	Professional		$370.66	$466.98	$538.83
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 $246.62 / $364.95 / $674.17	Professional		$246.62	$364.95	$674.17