Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $315.00 / $1,571.00 / $5,206.50	Facility		$315.00	$1,571.00	$5,206.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $151.96 / $175.09 / $272.20	Facility	52	$151.96	$175.09	$272.20
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $227.94 / $279.05 / $418.27	Facility	54	$227.94	$279.05	$418.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $268.49 / $335.81 / $746.40	Professional		$268.49	$335.81	$746.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.43 / $392.34 / $1,001.80	Professional		$203.43	$392.34	$1,001.80
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 $294.75 / $421.40 / $755.47	Professional		$294.75	$421.40	$755.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $535.65 / $653.10 / $888.53	Facility		$535.65	$653.10	$888.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $523.77 / $640.00	Facility		$177.38	$523.77	$640.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $366.64	Facility	54	$366.64	$366.64	$366.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.26 / $441.25 / $800.10	Professional		$295.26	$441.25	$800.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $356.60 / $481.08 / $851.79	Professional		$356.60	$481.08	$851.79
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $269.02 / $269.02 / $298.13	Professional	52	$269.02	$269.02	$298.13
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $430.44 / $430.44 / $477.00	Professional	54	$430.44	$430.44	$477.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $462.48 / $570.70 / $697.82	Professional		$462.48	$570.70	$697.82
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 $270.64 / $414.00 / $776.39	Professional		$270.64	$414.00	$776.39