Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $502.72 / $3,360.00 / $6,915.00	Facility		$502.72	$3,360.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $370.18 / $377.04 / $637.21	Facility	54	$370.18	$377.04	$637.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.18 / $522.63 / $1,070.79	Professional		$428.18	$522.63	$1,070.79
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 $462.14 / $681.29 / $1,259.04	Professional		$462.14	$681.29	$1,259.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $837.60 / $1,018.37 / $1,385.28	Facility		$837.60	$1,018.37	$1,385.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $640.00 / $818.60	Facility		$177.38	$640.00	$818.60
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $573.02 / $573.02 / $573.02	Facility	54	$573.02	$573.02	$573.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $477.88 / $736.21 / $1,240.97	Professional		$477.88	$736.21	$1,240.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $541.02 / $737.76 / $1,219.20	Professional		$541.02	$737.76	$1,219.20
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $671.12 / $671.12 / $682.75	Professional	54	$671.12	$671.12	$682.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $772.68 / $872.57 / $909.90	Professional		$772.68	$872.57	$909.90
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 $425.69 / $638.54 / $1,120.08	Professional		$425.69	$638.54	$1,120.08