Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $541.80 / $2,800.00 / $6,915.00	Facility		$541.80	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $373.13 / $483.66 / $670.65	Facility	54	$373.13	$483.66	$670.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $441.97 / $541.80 / $1,085.90	Professional		$441.97	$541.80	$1,085.90
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 $484.57 / $701.51 / $1,260.89	Professional		$484.57	$701.51	$1,260.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $843.50 / $1,020.74 / $1,388.51	Facility		$843.50	$1,020.74	$1,388.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $640.00 / $823.44	Facility		$177.38	$640.00	$823.44
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $576.41 / $576.41 / $576.41	Facility	54	$576.41	$576.41	$576.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.62 / $775.03 / $1,279.22	Professional		$506.62	$775.03	$1,279.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $557.26 / $752.93 / $1,308.31	Professional		$557.26	$752.93	$1,308.31
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $672.67 / $672.67 / $732.65	Professional	54	$672.67	$672.67	$732.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $777.99 / $896.45 / $976.41	Professional		$777.99	$896.45	$976.41
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 $460.14 / $689.81 / $1,199.15	Professional		$460.14	$689.81	$1,199.15