Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,737.80 / $6,165.95	Facility		$346.74	$1,737.80	$6,165.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $91.20 / $173.78 / $275.42	Facility	53	$91.20	$173.78	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $389.05 / $1,148.15	Professional		$181.97	$389.05	$1,148.15
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $158.49 / $295.12	Professional	53	$83.18	$158.49	$295.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $3,467.37 / $8,511.38	Facility		$2,454.71	$3,467.37	$8,511.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $257.04 / $371.54	Professional		$204.17	$257.04	$371.54
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $91.20 / $169.82 / $169.82	Professional	53	$91.20	$169.82	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,862.09	Facility		$794.33	$794.33	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $363.08 / $602.56	Professional		$223.87	$363.08	$602.56
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $144.54 / $218.78 / $363.08	Professional	53	$144.54	$218.78	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $389.05 / $891.25	Professional		$165.96	$389.05	$891.25
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $125.89 / $295.12	Professional	53	$83.18	$125.89	$295.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $338.84 / $416.87	Professional		$165.96	$338.84	$416.87
Select Health Facility/Professional Professional Modifier 53 Low / Median / High Price $109.65 / $223.87 / $263.03	Professional	53	$109.65	$223.87	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,884.03 / $5,495.41	Facility		$1,348.96	$2,884.03	$5,495.41
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $371.54 / $660.69	Professional		$218.78	$371.54	$660.69
United Facility/Professional Professional Modifier 53 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	53	$218.78	$218.78	$218.78