Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.01 / $2,540.30 / $6,726.00	Facility		$489.01	$2,540.30	$6,726.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $330.09 / $437.27 / $626.52	Facility	54	$330.09	$437.27	$626.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.50 / $489.01 / $1,001.81	Professional		$393.50	$489.01	$1,001.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $553.64 / $553.64 / $553.64	Professional		$553.64	$553.64	$553.64
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 $435.90 / $624.00 / $1,134.38	Professional		$435.90	$624.00	$1,134.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $755.87 / $918.21 / $1,249.04	Facility		$755.87	$918.21	$1,249.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $738.59 / $1,153.31	Facility		$640.00	$738.59	$1,153.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $517.01	Facility	54	$517.01	$517.01	$517.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $460.00 / $697.74 / $1,162.27	Professional		$460.00	$697.74	$1,162.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.29 / $692.00 / $1,200.43	Professional		$501.29	$692.00	$1,200.43
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $605.09 / $605.09 / $672.24	Professional	54	$605.09	$605.09	$672.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $697.17 / $806.41 / $1,060.77	Professional		$697.17	$806.41	$1,060.77
United Facility/Professional Facility Modifier Low / Median / High Price $426.00 / $2,360.00 / $4,066.00	Facility		$426.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $412.95 / $632.44 / $1,100.48	Professional		$412.95	$632.44	$1,100.48