Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $3,235.94 / $7,413.10	Facility		$371.54	$3,235.94	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $851.14	Professional		$295.12	$426.58	$851.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,047.13 / $1,047.13 / $1,380.38	Professional	50	$1,047.13	$1,047.13	$1,380.38
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $288.40 / $467.74 / $1,288.25	Professional	54	$288.40	$467.74	$1,288.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $446.68 / $812.83	Professional		$213.80	$446.68	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $2,089.30 / $3,548.13	Facility		$758.58	$2,089.30	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $645.65	Professional		$288.40	$436.52	$645.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $660.69 / $977.24	Professional	50	$446.68	$660.69	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $467.74 / $645.65	Facility		$380.19	$467.74	$645.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $407.38 / $478.63	Professional		$316.23	$407.38	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $562.34 / $2,511.89	Facility		$177.83	$562.34	$2,511.89
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	54	$389.05	$389.05	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $467.74 / $812.83	Professional		$302.00	$467.74	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $512.86 / $2,570.40	Professional		$389.05	$512.86	$2,570.40
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $467.74 / $467.74 / $489.78	Professional	54	$467.74	$467.74	$489.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $645.65 / $724.44	Professional		$630.96	$645.65	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,479.11 / $2,511.89	Facility		$177.83	$1,479.11	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $758.58	Professional		$257.04	$389.05	$758.58