Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $404.13 / $2,987.00 / $6,915.00	Facility		$404.13	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $299.93 / $303.10 / $519.08	Facility	54	$299.93	$303.10	$519.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.54 / $420.99 / $884.22	Professional		$349.54	$420.99	$884.22
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 $391.73 / $563.22 / $1,019.02	Professional		$391.73	$563.22	$1,019.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $681.66 / $827.63 / $1,125.83	Facility		$681.66	$827.63	$1,125.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $640.00 / $665.91	Facility		$177.38	$640.00	$665.91
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $466.14 / $466.14 / $466.14	Facility	54	$466.14	$466.14	$466.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.73 / $603.89 / $1,003.71	Professional		$399.73	$603.89	$1,003.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $435.74 / $594.20 / $981.93	Professional		$435.74	$594.20	$981.93
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $545.41 / $545.41 / $549.88	Professional	54	$545.41	$545.41	$549.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $628.73 / $701.19 / $732.84	Professional		$628.73	$701.19	$732.84
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 $343.26 / $538.58 / $898.69	Professional		$343.26	$538.58	$898.69