Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.14 / $2,592.00 / $6,915.00	Facility		$304.14	$2,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $208.06 / $231.51 / $368.64	Facility	54	$208.06	$231.51	$368.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.30 / $304.14 / $596.95	Professional		$240.30	$304.14	$596.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $395.95 / $395.95 / $395.95	Professional		$395.95	$395.95	$395.95
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 $268.14 / $385.22 / $710.72	Professional		$268.14	$385.22	$710.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $473.88 / $582.71 / $792.65	Facility		$473.88	$582.71	$792.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $464.51 / $640.00	Facility		$177.38	$464.51	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.42 / $408.59 / $715.60	Professional		$263.42	$408.59	$715.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $318.12 / $395.14 / $749.67	Professional		$318.12	$395.14	$749.67
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $384.00 / $384.00 / $419.82	Professional	54	$384.00	$384.00	$419.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $437.09 / $502.03 / $559.50	Professional		$437.09	$502.03	$559.50
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 $251.69 / $383.38 / $681.10	Professional		$251.69	$383.38	$681.10