Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.44 / $2,595.00 / $6,915.00	Facility		$361.44	$2,595.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $250.77 / $305.60 / $438.01	Facility	54	$250.77	$305.60	$438.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.25 / $366.29 / $716.31	Professional		$292.25	$366.29	$716.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $475.24 / $475.24 / $475.24	Professional		$475.24	$475.24	$475.24
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 $321.45 / $466.10 / $855.63	Professional		$321.45	$466.10	$855.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $568.79 / $698.03 / $949.52	Facility		$568.79	$698.03	$949.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $557.42 / $640.00	Facility		$177.38	$557.42	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $390.20 / $390.20 / $390.20	Facility	54	$390.20	$390.20	$390.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.32 / $508.94 / $859.67	Professional		$328.32	$508.94	$859.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $381.09 / $500.05 / $885.38	Professional		$381.09	$500.05	$885.38
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $460.00 / $460.00 / $495.81	Professional	54	$460.00	$460.00	$495.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $524.62 / $613.04 / $744.88	Professional		$524.62	$613.04	$744.88
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 $304.00 / $474.74 / $889.06	Professional		$304.00	$474.74	$889.06