Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $226.07 / $2,592.00 / $6,915.00	Facility		$226.07	$2,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $158.47 / $188.48 / $275.70	Facility	54	$158.47	$188.48	$275.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.68 / $238.50 / $508.70	Professional		$187.68	$238.50	$508.70
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $139.52 / $171.11 / $356.45	Professional	54	$139.52	$171.11	$356.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $265.69 / $294.64 / $410.31	Professional		$265.69	$294.64	$410.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.90 / $293.60 / $526.71	Professional		$198.90	$293.60	$526.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $216.07 / $280.62 / $387.06	Facility		$216.07	$280.62	$387.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $204.26 / $262.07 / $282.23	Professional		$204.26	$262.07	$282.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.38 / $351.09 / $2,500.00	Facility		$177.38	$351.09	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.76 / $245.76 / $245.76	Facility	54	$245.76	$245.76	$245.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.55 / $317.79 / $530.29	Professional		$205.55	$317.79	$530.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $240.06 / $331.50 / $547.82	Professional		$240.06	$331.50	$547.82
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $289.77 / $289.77 / $306.77	Professional	54	$289.77	$289.77	$306.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $286.13 / $347.45 / $397.80	Professional		$286.13	$347.45	$397.80
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 $191.12 / $290.05 / $502.59	Professional		$191.12	$290.05	$502.59