Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $482.92 / $4,592.00 / $6,915.00	Facility		$482.92	$4,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $231.14 / $362.19 / $581.90	Facility	54	$231.14	$362.19	$581.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $875.94 / $2,260.19 / $3,862.88	Facility		$875.94	$2,260.19	$3,862.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $364.88 / $543.64 / $685.33	Professional		$364.88	$543.64	$685.33
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $415.97 / $415.97 / $619.76	Professional	54	$415.97	$415.97	$619.76
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00