Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.83 / $2,592.00 / $6,915.00	Facility		$124.83	$2,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $92.04 / $107.24 / $162.97	Facility	54	$92.04	$107.24	$162.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.54 / $133.68 / $287.14	Professional		$109.54	$133.68	$287.14
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $80.50 / $96.05 / $209.16	Professional	54	$80.50	$96.05	$209.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $178.79 / $178.79	Professional		$97.02	$178.79	$178.79
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $79.90 / $79.90 / $175.78	Professional	54	$79.90	$79.90	$175.78
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 $111.96 / $172.03 / $316.45	Professional		$111.96	$172.03	$316.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $166.81 / $166.81 / $166.81	Facility		$166.81	$166.81	$166.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.37 / $141.36 / $2,500.00	Facility		$110.37	$141.36	$2,500.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $94.65 / $94.65 / $94.65	Facility	54	$94.65	$94.65	$94.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.71 / $183.60 / $309.06	Professional		$117.71	$183.60	$309.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.80 / $195.63 / $942.84	Professional		$141.80	$195.63	$942.84
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $171.15 / $171.15 / $171.15	Professional	54	$171.15	$171.15	$171.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.71 / $203.20 / $228.10	Professional		$169.71	$203.20	$228.10
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 $106.30 / $158.81 / $278.93	Professional		$106.30	$158.81	$278.93