Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.61 / $2,595.00 / $6,915.00	Facility		$331.61	$2,595.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.16 / $288.42 / $405.93	Facility	54	$238.16	$288.42	$405.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.95 / $347.80 / $733.75	Professional		$275.95	$347.80	$733.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.23 / $407.23 / $424.56	Professional		$407.23	$407.23	$424.56
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 $294.14 / $438.76 / $805.43	Professional		$294.14	$438.76	$805.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $539.66 / $661.17 / $899.39	Facility		$539.66	$661.17	$899.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $528.76 / $640.00	Facility		$177.38	$528.76	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $370.13	Facility	54	$370.13	$370.13	$370.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.61 / $464.67 / $807.44	Professional		$307.61	$464.67	$807.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $356.26 / $476.64 / $802.82	Professional		$356.26	$476.64	$802.82
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $435.70 / $435.70 / $449.58	Professional	54	$435.70	$435.70	$449.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $492.37 / $560.16 / $671.35	Professional		$492.37	$560.16	$671.35
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 $279.06 / $415.41 / $738.49	Professional		$279.06	$415.41	$738.49