Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.54 / $1,444.00 / $4,733.00	Facility		$118.54	$1,444.00	$4,733.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $66.20 / $85.42 / $135.04	Facility	54	$66.20	$85.42	$135.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.28 / $117.38 / $230.34	Professional		$88.28	$117.38	$230.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.08 / $172.97 / $231.17	Professional		$107.08	$172.97	$231.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,080.80 / $3,851.83	Facility		$734.14	$2,080.80	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.53 / $140.71 / $258.14	Professional		$98.53	$140.71	$258.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.18 / $126.19 / $355.32	Facility		$98.18	$126.19	$355.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.31 / $136.96 / $144.69	Professional		$115.31	$136.96	$144.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.89 / $139.35 / $269.16	Professional		$94.89	$139.35	$269.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $136.96 / $174.31	Professional		$115.68	$136.96	$174.31
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $98.95 / $98.95 / $117.15	Professional	54	$98.95	$98.95	$117.15
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $873.99 / $1,261.90 / $1,750.00	Facility		$873.99	$1,261.90	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.67 / $161.43 / $204.51	Professional		$112.67	$161.43	$204.51
United Facility/Professional Facility Modifier Low / Median / High Price $389.00 / $1,550.00 / $2,506.00	Facility		$389.00	$1,550.00	$2,506.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.32 / $142.81 / $285.17	Professional		$99.32	$142.81	$285.17