Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $541.75 / $3,778.39 / $6,726.00	Facility		$541.75	$3,778.39	$6,726.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $99.14 / $205.62	Facility	53	$28.11	$99.14	$205.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.66 / $371.67 / $1,079.19	Professional		$151.66	$371.67	$1,079.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.16 / $206.15 / $900.13	Professional		$157.16	$206.15	$900.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $996.37 / $2,722.51 / $5,292.58	Facility		$996.37	$2,722.51	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.91 / $443.22 / $1,114.68	Professional		$192.91	$443.22	$1,114.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $183.24 / $221.42 / $352.97	Facility		$183.24	$221.42	$352.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $571.77 / $575.79 / $986.99	Professional		$571.77	$575.79	$986.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $894.69 / $894.69 / $894.69	Facility		$894.69	$894.69	$894.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.39 / $689.26 / $1,330.48	Professional		$223.39	$689.26	$1,330.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $172.88 / $518.40 / $3,221.00	Professional		$172.88	$518.40	$3,221.00
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $106.81 / $106.81 / $320.27	Professional	53	$106.81	$106.81	$320.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $211.89 / $603.26 / $777.60	Professional		$211.89	$603.26	$777.60
United Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $3,218.00 / $5,272.00	Facility		$607.00	$3,218.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $624.76 / $893.41 / $1,270.15	Professional		$624.76	$893.41	$1,270.15