Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.44 / $2,987.00 / $6,915.00	Facility		$235.44	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $173.15 / $198.72 / $290.77	Facility	54	$173.15	$198.72	$290.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.48 / $246.22 / $510.24	Professional		$197.48	$246.22	$510.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $207.41 / $220.55 / $464.85	Professional		$207.41	$220.55	$464.85
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 $210.03 / $325.37 / $595.27	Professional		$210.03	$325.37	$595.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $406.50 / $478.23 / $680.90	Facility		$406.50	$478.23	$680.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $265.22 / $640.00	Facility		$177.38	$265.22	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $183.20	Facility	54	$183.20	$183.20	$183.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.05 / $331.74 / $593.39	Professional		$217.05	$331.74	$593.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $261.39 / $346.32 / $589.04	Professional		$261.39	$346.32	$589.04
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $322.26 / $322.26 / $329.87	Professional	54	$322.26	$322.26	$329.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $332.68 / $382.24 / $438.52	Professional		$332.68	$382.24	$438.52
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 $188.64 / $287.20 / $522.53	Professional		$188.64	$287.20	$522.53