Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $567.65 / $3,911.00 / $6,915.00	Facility		$567.65	$3,911.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $159.24 / $280.66 / $400.58	Facility	52	$159.24	$280.66	$400.58
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $63.70 / $112.27 / $160.22	Facility	53	$63.70	$112.27	$160.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $572.89 / $2,098.00 / $6,065.87	Facility		$572.89	$2,098.00	$6,065.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $517.22 / $517.22 / $517.22	Facility		$517.22	$517.22	$517.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $448.00 / $715.00 / $2,369.50	Facility		$448.00	$715.00	$2,369.50
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $283.33 / $283.33 / $283.33	Facility	52	$283.33	$283.33	$283.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $70.84 / $70.84 / $70.84	Facility	53	$70.84	$70.84	$70.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $310.18 / $403.23 / $1,035.46	Professional		$310.18	$403.23	$1,035.46
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $254.17 / $254.17 / $324.43	Professional	52	$254.17	$254.17	$324.43
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $254.17 / $254.17 / $421.76	Professional	53	$254.17	$254.17	$421.76
United Facility/Professional Facility Modifier Low / Median / High Price $576.00 / $3,895.00 / $6,995.00	Facility		$576.00	$3,895.00	$6,995.00