Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.76 / $4,014.00 / $6,726.00	Facility		$354.76	$4,014.00	$6,726.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $236.53 / $297.04 / $431.90	Facility	54	$236.53	$297.04	$431.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.32 / $354.76 / $745.37	Professional		$276.32	$354.76	$745.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $291.24 / $291.24 / $291.24	Professional		$291.24	$291.24	$291.24
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 $313.74 / $440.18 / $813.46	Professional		$313.74	$440.18	$813.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $502.30 / $502.30 / $502.30	Facility		$502.30	$502.30	$502.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $529.57 / $2,500.00	Facility		$177.38	$529.57	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $370.70 / $370.70 / $370.70	Facility	54	$370.70	$370.70	$370.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.45 / $475.01 / $829.81	Professional		$307.45	$475.01	$829.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $360.80 / $492.51 / $872.03	Professional		$360.80	$492.51	$872.03
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $435.51 / $435.51 / $488.34	Professional	54	$435.51	$435.51	$488.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $425.53 / $521.50 / $627.82	Professional		$425.53	$521.50	$627.82
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 $298.66 / $461.95 / $792.27	Professional		$298.66	$461.95	$792.27