Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.55 / $2,760.00 / $6,915.00	Facility		$145.55	$2,760.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $95.18 / $110.22 / $178.29	Facility	54	$95.18	$110.22	$178.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.80 / $145.55 / $316.75	Professional		$118.80	$145.55	$316.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.93 / $117.93 / $117.93	Professional		$117.93	$117.93	$117.93
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 $125.04 / $177.99 / $326.74	Professional		$125.04	$177.99	$326.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $217.37 / $268.64 / $365.45	Facility		$217.37	$268.64	$365.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.28 / $214.05 / $2,500.00	Facility		$139.28	$214.05	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $149.84 / $149.84 / $149.84	Facility	54	$149.84	$149.84	$149.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $193.84 / $340.10	Professional		$130.82	$193.84	$340.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.66 / $186.30 / $358.51	Professional		$146.66	$186.30	$358.51
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $177.04 / $177.04 / $200.77	Professional	54	$177.04	$177.04	$200.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $179.51 / $224.00 / $260.32	Professional		$179.51	$224.00	$260.32
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 $122.26 / $183.15 / $325.70	Professional		$122.26	$183.15	$325.70