Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $388.32 / $2,572.00 / $6,915.00	Facility		$388.32	$2,572.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $272.51 / $327.98 / $481.71	Facility	54	$272.51	$327.98	$481.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.50 / $408.10 / $786.82	Professional		$322.50	$408.10	$786.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $571.23 / $571.23 / $571.23	Professional		$571.23	$571.23	$571.23
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 $350.83 / $505.26 / $931.16	Professional		$350.83	$505.26	$931.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $619.41 / $759.86 / $1,033.64	Facility		$619.41	$759.86	$1,033.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $606.91 / $640.00	Facility		$177.38	$606.91	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $424.84 / $424.84 / $424.84	Facility	54	$424.84	$424.84	$424.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.38 / $536.98 / $945.00	Professional		$353.38	$536.98	$945.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $414.84 / $580.19 / $976.52	Professional		$414.84	$580.19	$976.52
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $500.74 / $500.74 / $546.85	Professional	54	$500.74	$500.74	$546.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $566.19 / $653.96 / $728.81	Professional		$566.19	$653.96	$728.81
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 $330.96 / $500.71 / $893.06	Professional		$330.96	$500.71	$893.06