Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.56 / $2,760.00 / $6,915.00	Facility		$318.56	$2,760.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $228.37 / $266.36 / $387.95	Facility	54	$228.37	$266.36	$387.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.38 / $330.13 / $681.46	Professional		$260.38	$330.13	$681.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $381.26 / $381.26 / $381.26	Professional		$381.26	$381.26	$381.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $2,067.41 / $3,851.83	Facility		$635.46	$2,067.41	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.83 / $421.00 / $772.85	Professional		$278.83	$421.00	$772.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.89 / $416.89 / $416.89	Facility		$416.89	$416.89	$416.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $506.07 / $640.00	Facility		$177.38	$506.07	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.39 / $446.96 / $781.62	Professional		$286.39	$446.96	$781.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $344.51 / $469.79 / $776.35	Professional		$344.51	$469.79	$776.35
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $415.95 / $415.95 / $434.76	Professional	54	$415.95	$415.95	$434.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $553.97 / $553.97 / $563.75	Professional		$553.97	$553.97	$563.75
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $260.25 / $392.19 / $711.12	Professional		$260.25	$392.19	$711.12