Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $327.31 / $2,438.00 / $6,915.00	Facility		$327.31	$2,438.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $224.38 / $271.33 / $399.90	Facility	54	$224.38	$271.33	$399.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.58 / $341.75 / $735.40	Professional		$261.58	$341.75	$735.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.49 / $401.60 / $648.30	Professional		$273.49	$401.60	$648.30
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 $288.75 / $413.63 / $759.30	Professional		$288.75	$413.63	$759.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $304.57 / $423.91 / $727.97	Facility		$304.57	$423.91	$727.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $294.49 / $380.41 / $409.67	Professional		$294.49	$380.41	$409.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $494.57 / $640.00	Facility		$177.38	$494.57	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $346.20 / $346.20 / $346.20	Facility	54	$346.20	$346.20	$346.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.42 / $448.13 / $762.89	Professional		$296.42	$448.13	$762.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $337.81 / $449.18 / $795.29	Professional		$337.81	$449.18	$795.29
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $407.76 / $407.76 / $445.36	Professional	54	$407.76	$407.76	$445.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $461.31 / $543.44 / $657.75	Professional		$461.31	$543.44	$657.75
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 $276.00 / $421.62 / $728.72	Professional		$276.00	$421.62	$728.72