Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $441.34 / $2,592.00 / $6,915.00	Facility		$441.34	$2,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $299.36 / $382.48 / $542.67	Facility	54	$299.36	$382.48	$542.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.40 / $441.34 / $922.38	Professional		$354.40	$441.34	$922.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $248.68 / $248.68 / $248.68	Professional		$248.68	$248.68	$248.68
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 $391.96 / $560.02 / $1,020.60	Professional		$391.96	$560.02	$1,020.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $679.04 / $798.86 / $1,124.69	Facility		$679.04	$798.86	$1,124.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $640.00 / $664.33	Facility		$177.38	$640.00	$664.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $465.03	Facility	54	$465.03	$465.03	$465.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.99 / $610.47 / $1,041.85	Professional		$399.99	$610.47	$1,041.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $451.39 / $613.00 / $1,076.08	Professional		$451.39	$613.00	$1,076.08
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $544.86 / $544.86 / $602.61	Professional	54	$544.86	$544.86	$602.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $626.29 / $726.14 / $940.37	Professional		$626.29	$726.14	$940.37
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 $382.28 / $602.88 / $1,080.54	Professional		$382.28	$602.88	$1,080.54