Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $255.44 / $3,391.00 / $6,915.00	Facility		$255.44	$3,391.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $176.81 / $191.58 / $334.22	Facility	54	$176.81	$191.58	$334.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.51 / $257.42 / $558.32	Professional		$209.51	$257.42	$558.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.36 / $334.93 / $481.34	Professional		$146.36	$334.93	$481.34
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 $226.80 / $330.42 / $608.48	Professional		$226.80	$330.42	$608.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $400.88 / $493.47 / $671.28	Facility		$400.88	$493.47	$671.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $394.02 / $640.00	Facility		$177.38	$394.02	$640.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $275.81 / $275.81 / $275.81	Facility	54	$275.81	$275.81	$275.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.44 / $367.21 / $607.29	Professional		$233.44	$367.21	$607.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.41 / $374.83 / $624.67	Professional		$269.41	$374.83	$624.67
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $325.20 / $325.20 / $349.82	Professional	54	$325.20	$325.20	$349.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $326.48 / $396.44 / $453.61	Professional		$326.48	$396.44	$453.61
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 $217.18 / $332.64 / $571.92	Professional		$217.18	$332.64	$571.92