Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.25 / $2,595.00 / $6,915.00	Facility		$207.25	$2,595.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $145.66 / $163.19 / $249.11	Facility	54	$145.66	$163.19	$249.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.57 / $211.86 / $462.38	Professional		$172.57	$211.86	$462.38
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $127.65 / $155.44 / $327.33	Professional	54	$127.65	$155.44	$327.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.34 / $193.34 / $251.34	Professional		$193.34	$193.34	$251.34
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $108.41 / $108.41 / $108.41	Professional	54	$108.41	$108.41	$108.41
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 $184.74 / $268.26 / $490.49	Professional		$184.74	$268.26	$490.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $274.83 / $274.83 / $274.83	Facility		$274.83	$274.83	$274.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $329.43 / $2,500.00	Facility		$177.38	$329.43	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $230.60	Facility	54	$230.60	$230.60	$230.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.57 / $280.48 / $499.80	Professional		$183.57	$280.48	$499.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $226.27 / $281.23 / $518.90	Professional		$226.27	$281.23	$518.90
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $273.13 / $273.13 / $290.58	Professional	54	$273.13	$273.13	$290.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $268.85 / $319.73 / $373.76	Professional		$268.85	$319.73	$373.76
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 $170.82 / $255.83 / $471.45	Professional		$170.82	$255.83	$471.45