Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.74 / $2,760.00 / $6,915.00	Facility		$294.74	$2,760.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $199.69 / $227.18 / $351.99	Facility	54	$199.69	$227.18	$351.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.03 / $299.87 / $640.99	Professional		$235.03	$299.87	$640.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $272.81 / $272.81 / $272.81	Professional		$272.81	$272.81	$272.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.37 / $366.45 / $665.28	Professional		$255.37	$366.45	$665.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $458.09 / $563.09 / $766.37	Facility		$458.09	$563.09	$766.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $449.16 / $2,500.00	Facility		$177.38	$449.16	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $314.41	Facility	54	$314.41	$314.41	$314.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.81 / $385.38 / $683.26	Professional		$253.81	$385.38	$683.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $307.58 / $422.53 / $730.94	Professional		$307.58	$422.53	$730.94
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $371.27 / $371.27 / $409.33	Professional	54	$371.27	$371.27	$409.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $374.44 / $463.64 / $554.34	Professional		$374.44	$463.64	$554.34
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 $241.36 / $357.91 / $666.27	Professional		$241.36	$357.91	$666.27