Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.52 / $2,987.00 / $6,915.00	Facility		$275.52	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $188.98 / $217.37 / $330.47	Facility	54	$188.98	$217.37	$330.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.09 / $275.52 / $554.35	Professional		$224.09	$275.52	$554.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.86 / $204.86 / $393.02	Professional		$204.86	$204.86	$393.02
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 $242.31 / $347.04 / $636.37	Professional		$242.31	$347.04	$636.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $431.54 / $532.89 / $724.89	Facility		$431.54	$532.89	$724.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $423.44 / $2,500.00	Facility		$177.38	$423.44	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $296.41 / $296.41 / $296.41	Facility	54	$296.41	$296.41	$296.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.25 / $371.42 / $645.60	Professional		$237.25	$371.42	$645.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $290.93 / $399.55 / $681.47	Professional		$290.93	$399.55	$681.47
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $351.18 / $351.18 / $381.62	Professional	54	$351.18	$351.18	$381.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $354.17 / $431.05 / $512.19	Professional		$354.17	$431.05	$512.19
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 $230.33 / $348.61 / $683.87	Professional		$230.33	$348.61	$683.87