Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $342.62 / $2,960.00 / $6,915.00	Facility		$342.62	$2,960.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $231.11 / $281.02 / $411.47	Facility	54	$231.11	$281.02	$411.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.08 / $337.16 / $606.90	Professional		$266.08	$337.16	$606.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $342.08 / $342.08 / $439.70	Professional		$342.08	$342.08	$439.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $746.52 / $2,085.16 / $3,851.83	Facility		$746.52	$2,085.16	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.58 / $429.46 / $788.37	Professional		$302.58	$429.46	$788.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $462.67 / $462.67 / $462.67	Facility		$462.67	$462.67	$462.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $514.65 / $860.00	Facility		$177.38	$514.65	$860.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $360.25 / $360.25 / $360.25	Facility	54	$360.25	$360.25	$360.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.94 / $454.75 / $799.00	Professional		$309.94	$454.75	$799.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $352.25 / $474.88 / $840.82	Professional		$352.25	$474.88	$840.82
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $425.20 / $425.20 / $470.86	Professional	54	$425.20	$425.20	$470.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $412.08 / $501.55 / $599.29	Professional		$412.08	$501.55	$599.29
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 $271.70 / $427.25 / $786.27	Professional		$271.70	$427.25	$786.27