Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.22 / $2,800.00 / $6,915.00	Facility		$346.22	$2,800.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $239.09 / $289.49 / $422.10	Facility	54	$239.09	$289.49	$422.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.69 / $346.22 / $688.95	Professional		$276.69	$346.22	$688.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $413.79 / $413.79 / $413.79	Professional		$413.79	$413.79	$413.79
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 $308.98 / $443.53 / $814.20	Professional		$308.98	$443.53	$814.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $543.51 / $667.49 / $907.98	Facility		$543.51	$667.49	$907.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $533.14 / $640.00	Facility		$177.38	$533.14	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $373.20 / $373.20 / $373.20	Facility	54	$373.20	$373.20	$373.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.74 / $473.06 / $823.98	Professional		$307.74	$473.06	$823.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $364.41 / $480.65 / $851.04	Professional		$364.41	$480.65	$851.04
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $439.87 / $439.87 / $476.58	Professional	54	$439.87	$439.87	$476.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $501.30 / $585.95 / $707.72	Professional		$501.30	$585.95	$707.72
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 $293.27 / $444.94 / $775.50	Professional		$293.27	$444.94	$775.50