Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.37 / $2,760.00 / $6,915.00	Facility		$349.37	$2,760.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.02 / $284.17 / $421.58	Facility	54	$238.02	$284.17	$421.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.80 / $349.37 / $739.32	Professional		$283.80	$349.37	$739.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $449.99 / $556.84 / $556.84	Professional		$449.99	$556.84	$556.84
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 $311.00 / $441.22 / $809.96	Professional		$311.00	$441.22	$809.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $538.58 / $662.70 / $901.46	Facility		$538.58	$662.70	$901.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $528.16 / $640.00	Facility		$177.38	$528.16	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $369.72	Facility	54	$369.72	$369.72	$369.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.10 / $469.81 / $820.73	Professional		$306.10	$469.81	$820.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $361.79 / $483.78 / $856.59	Professional		$361.79	$483.78	$856.59
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $436.71 / $436.71 / $479.69	Professional	54	$436.71	$436.71	$479.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $582.01 / $719.79	Professional		$496.74	$582.01	$719.79
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 $293.14 / $440.39 / $782.10	Professional		$293.14	$440.39	$782.10