Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $923.28 / $3,295.00 / $6,915.00	Facility		$923.28	$3,295.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $301.80 / $399.26 / $522.00	Facility	52	$301.80	$399.26	$522.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $452.70 / $598.88 / $783.00	Facility	54	$452.70	$598.88	$783.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $869.00 / $2,292.94 / $5,240.56	Facility		$869.00	$2,292.94	$5,240.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,017.66 / $1,229.55 / $1,672.55	Facility		$1,017.66	$1,229.55	$1,672.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $664.73 / $664.73 / $1,153.31	Facility		$664.73	$664.73	$1,153.31
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $530.59 / $530.59 / $530.59	Facility	52	$530.59	$530.59	$530.59
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $464.27 / $464.27 / $464.27	Facility	54	$464.27	$464.27	$464.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $642.08 / $913.03 / $1,446.89	Professional		$642.08	$913.03	$1,446.89
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $506.41 / $506.41 / $506.41	Professional	52	$506.41	$506.41	$506.41
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $810.26 / $810.26 / $810.26	Professional	54	$810.26	$810.26	$810.26
United Facility/Professional Facility Modifier Low / Median / High Price $625.00 / $3,218.00 / $5,272.00	Facility		$625.00	$3,218.00	$5,272.00