Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.50 / $4,368.00 / $6,915.00	Facility		$72.50	$4,368.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $20.02 / $33.68 / $60.26	Facility	52	$20.02	$33.68	$60.26
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $8.01 / $13.47 / $23.13	Facility	53	$8.01	$13.47	$23.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $1,729.39 / $3,784.98	Facility		$480.00	$1,729.39	$3,784.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.07 / $63.07 / $63.07	Facility		$63.07	$63.07	$63.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $232.08 / $324.22 / $631.54	Facility		$232.08	$324.22	$631.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.19 / $35.19 / $35.19	Facility	52	$35.19	$35.19	$35.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $8.80 / $8.80 / $8.80	Facility	53	$8.80	$8.80	$8.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.88 / $50.54 / $149.50	Professional		$38.88	$50.54	$149.50
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $31.86 / $31.86 / $40.67	Professional	52	$31.86	$31.86	$40.67
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $31.86 / $31.86 / $52.87	Professional	53	$31.86	$31.86	$52.87
United Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $1,249.00 / $2,483.00	Facility		$105.00	$1,249.00	$2,483.00