Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $321.32 / $2,800.00 / $6,915.00	Facility		$321.32	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $221.47 / $247.23 / $387.96	Facility	54	$221.47	$247.23	$387.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.66 / $321.32 / $630.57	Professional		$252.66	$321.32	$630.57
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 $287.07 / $410.42 / $751.51	Professional		$287.07	$410.42	$751.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $503.06 / $618.91 / $841.91	Facility		$503.06	$618.91	$841.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $493.23 / $640.00	Facility		$177.38	$493.23	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $345.26 / $345.26 / $345.26	Facility	54	$345.26	$345.26	$345.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.44 / $429.99 / $758.62	Professional		$278.44	$429.99	$758.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.89 / $426.03 / $790.68	Professional		$337.89	$426.03	$790.68
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $407.86 / $407.86 / $442.78	Professional	54	$407.86	$407.86	$442.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $463.98 / $543.57 / $665.49	Professional		$463.98	$543.57	$665.49
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 $269.55 / $400.41 / $720.56	Professional		$269.55	$400.41	$720.56