Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.37 / $2,800.00 / $6,915.00	Facility		$338.37	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $233.73 / $276.66 / $408.20	Facility	54	$233.73	$276.66	$408.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.51 / $338.37 / $692.66	Professional		$266.51	$338.37	$692.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.19 / $144.19 / $444.14	Professional		$144.19	$144.19	$444.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $2,067.41 / $3,851.83	Facility		$635.46	$2,067.41	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.08 / $434.56 / $797.72	Professional		$302.08	$434.56	$797.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $531.55 / $625.37 / $888.78	Facility		$531.55	$625.37	$888.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $520.98 / $640.00	Facility		$177.38	$520.98	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $364.69	Facility	54	$364.69	$364.69	$364.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.49 / $459.16 / $805.56	Professional		$298.49	$459.16	$805.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $356.70 / $469.91 / $832.02	Professional		$356.70	$469.91	$832.02
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $430.57 / $430.57 / $465.93	Professional	54	$430.57	$430.57	$465.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $500.09 / $589.08 / $620.95	Professional		$500.09	$589.08	$620.95
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 $283.33 / $426.76 / $759.54	Professional		$283.33	$426.76	$759.54