Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $709.09 / $3,391.00 / $6,915.00	Facility		$709.09	$3,391.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $362.03 / $459.95 / $618.36	Facility	54	$362.03	$459.95	$618.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.07 / $511.75 / $1,098.94	Professional		$418.07	$511.75	$1,098.94
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
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $464.33 / $665.61 / $1,230.07	Professional		$464.33	$665.61	$1,230.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $820.71 / $997.22 / $1,356.51	Facility		$820.71	$997.22	$1,356.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $539.75 / $539.75 / $1,153.31	Facility		$539.75	$539.75	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $375.54 / $375.54 / $375.54	Facility	54	$375.54	$375.54	$375.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $471.71 / $720.02 / $1,192.77	Professional		$471.71	$720.02	$1,192.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $520.75 / $722.48 / $1,173.50	Professional		$520.75	$722.48	$1,173.50
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $657.16 / $657.16 / $657.16	Professional	54	$657.16	$657.16	$657.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $748.90 / $844.87 / $875.81	Professional		$748.90	$844.87	$875.81
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 $410.45 / $632.16 / $1,074.14	Professional		$410.45	$632.16	$1,074.14