Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $545.10 / $2,800.00 / $6,915.00	Facility		$545.10	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $386.67 / $495.41 / $673.67	Facility	54	$386.67	$495.41	$673.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $449.59 / $546.84 / $1,111.04	Professional		$449.59	$546.84	$1,111.04
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 $482.16 / $722.00 / $1,310.27	Professional		$482.16	$722.00	$1,310.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $875.69 / $1,063.33 / $1,446.44	Facility		$875.69	$1,063.33	$1,446.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $640.00 / $855.54	Facility		$177.38	$640.00	$855.54
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $598.88 / $598.88 / $598.88	Facility	54	$598.88	$598.88	$598.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $504.99 / $773.83 / $1,320.78	Professional		$504.99	$773.83	$1,320.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $580.52 / $773.55 / $1,321.66	Professional		$580.52	$773.55	$1,321.66
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $700.73 / $700.73 / $740.13	Professional	54	$700.73	$700.73	$740.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $807.67 / $933.88 / $986.38	Professional		$807.67	$933.88	$986.38
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 $462.90 / $725.88 / $1,208.33	Professional		$462.90	$725.88	$1,208.33