Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.81 / $2,678.00 / $6,915.00	Facility		$346.81	$2,678.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.33 / $284.63 / $416.42	Facility	54	$245.33	$284.63	$416.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.89 / $354.94 / $761.41	Professional		$273.89	$354.94	$761.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $414.08 / $414.08 / $606.07	Professional		$414.08	$414.08	$606.07
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 $309.92 / $453.30 / $823.10	Professional		$309.92	$453.30	$823.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $558.12 / $688.01 / $935.90	Facility		$558.12	$688.01	$935.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $547.30 / $640.00	Facility		$177.38	$547.30	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $383.12 / $383.12 / $383.12	Facility	54	$383.12	$383.12	$383.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.04 / $473.58 / $834.98	Professional		$311.04	$473.58	$834.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $375.61 / $489.93 / $853.59	Professional		$375.61	$489.93	$853.59
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $453.39 / $453.39 / $478.01	Professional	54	$453.39	$453.39	$478.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $461.85 / $542.19 / $637.07	Professional		$461.85	$542.19	$637.07
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 $289.45 / $430.53 / $777.12	Professional		$289.45	$430.53	$777.12