Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $419.72 / $2,572.00 / $6,915.00	Facility		$419.72	$2,572.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $209.86 / $316.76 / $847.75	Facility	52	$209.86	$316.76	$847.75
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $314.79 / $407.09 / $532.98	Facility	54	$314.79	$407.09	$532.98
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
CareSource Facility/Professional Facility Modifier Low / Median / High Price $737.31 / $894.69 / $1,217.03	Facility		$737.31	$894.69	$1,217.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $483.95 / $640.00	Facility		$177.38	$483.95	$640.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $384.75 / $384.75 / $384.75	Facility	52	$384.75	$384.75	$384.75
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $336.66 / $336.66 / $336.66	Facility	54	$336.66	$336.66	$336.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.21 / $637.11 / $1,052.83	Professional		$467.21	$637.11	$1,052.83
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $368.49 / $368.49 / $368.49	Professional	52	$368.49	$368.49	$368.49
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $589.59 / $589.59 / $589.59	Professional	54	$589.59	$589.59	$589.59
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