Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $350.54 / $2,438.00 / $6,915.00	Facility		$350.54	$2,438.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $250.51 / $262.91 / $417.55	Facility	54	$250.51	$262.91	$417.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.20 / $363.63 / $788.87	Professional		$266.20	$363.63	$788.87
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $213.86 / $267.94 / $613.29	Professional	54	$213.86	$267.94	$613.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $322.36 / $419.07 / $615.79	Professional		$322.36	$419.07	$615.79
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 $296.79 / $445.45 / $797.70	Professional		$296.79	$445.45	$797.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $445.18 / $668.18 / $1,196.56	Professional	50	$445.18	$668.18	$1,196.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $345.99 / $469.97 / $831.92	Facility		$345.99	$469.97	$831.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $320.58 / $412.37 / $444.09	Professional		$320.58	$412.37	$444.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $560.70 / $2,500.00	Facility		$177.38	$560.70	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $392.49	Facility	54	$392.49	$392.49	$392.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.42 / $456.57 / $831.49	Professional		$291.42	$456.57	$831.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $384.87 / $522.24 / $867.31	Professional		$384.87	$522.24	$867.31
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $466.00 / $466.00 / $485.69	Professional	54	$466.00	$466.00	$485.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $464.43 / $557.25 / $653.77	Professional		$464.43	$557.25	$653.77
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 $274.57 / $406.94 / $790.61	Professional		$274.57	$406.94	$790.61