Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $556.94 / $3,018.00 / $6,915.00	Facility		$556.94	$3,018.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $381.83 / $505.04 / $695.48	Facility	54	$381.83	$505.04	$695.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.07 / $564.66 / $1,172.33	Professional		$455.07	$564.66	$1,172.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $278.35 / $549.16 / $701.72	Professional		$278.35	$549.16	$701.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,322.50 / $5,240.56	Facility		$741.08	$2,322.50	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.18 / $715.96 / $1,291.28	Professional		$496.18	$715.96	$1,291.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $862.25 / $1,045.17 / $1,421.75	Facility		$862.25	$1,045.17	$1,421.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $842.02 / $1,153.31	Facility		$640.00	$842.02	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $589.41	Facility	54	$589.41	$589.41	$589.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $531.61 / $784.88 / $1,305.83	Professional		$531.61	$784.88	$1,305.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $570.61 / $775.57 / $1,345.86	Professional		$570.61	$775.57	$1,345.86
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $688.77 / $688.77 / $753.68	Professional	54	$688.77	$688.77	$753.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $795.28 / $917.93 / $1,146.83	Professional		$795.28	$917.93	$1,146.83
United Facility/Professional Facility Modifier Low / Median / High Price $625.00 / $3,218.00 / $5,272.00	Facility		$625.00	$3,218.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $472.39 / $707.83 / $1,234.55	Professional		$472.39	$707.83	$1,234.55