Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.99 / $1,048.75 / $5,917.00	Facility		$205.99	$1,048.75	$5,917.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $34.75 / $93.99 / $158.10	Facility	52	$34.75	$93.99	$158.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $185.54 / $486.98	Professional		$69.50	$185.54	$486.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.29 / $91.85 / $175.46	Professional	52	$34.29	$91.85	$175.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,080.80 / $3,851.83	Facility		$734.14	$2,080.80	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $168.91 / $374.06	Professional		$73.44	$168.91	$374.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.03 / $84.76 / $93.84	Facility		$63.03	$84.76	$93.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $222.91 / $224.07 / $384.88	Professional		$222.91	$224.07	$384.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.93 / $131.93 / $131.93	Facility		$131.93	$131.93	$131.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.72 / $186.08 / $450.70	Professional		$86.72	$186.08	$450.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.33 / $202.71 / $257.99	Professional		$69.33	$202.71	$257.99
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $44.05 / $44.05 / $128.79	Professional	52	$44.05	$44.05	$128.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.76 / $116.61 / $302.55	Professional		$78.76	$116.61	$302.55
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $189.72 / $258.56 / $445.53	Professional		$189.72	$258.56	$445.53