Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.16 / $3,295.00 / $6,829.36	Facility		$274.16	$3,295.00	$6,829.36
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $71.64 / $137.08 / $261.86	Facility	52	$71.64	$137.08	$261.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.47 / $286.66 / $687.82	Professional		$142.47	$286.66	$687.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.21 / $215.67 / $427.64	Professional		$160.21	$215.67	$427.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $775.91 / $2,322.50 / $5,240.56	Facility		$775.91	$2,322.50	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.42 / $308.58 / $523.30	Professional		$171.42	$308.58	$523.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.25 / $172.54 / $191.02	Facility		$127.25	$172.54	$191.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $299.02 / $302.04 / $522.58	Professional		$299.02	$302.04	$522.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.62 / $1,000.62 / $1,000.62	Facility		$1,000.62	$1,000.62	$1,000.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.84 / $335.45 / $639.61	Professional		$176.84	$335.45	$639.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $268.39 / $922.80	Professional		$139.97	$268.39	$922.80
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $88.93 / $88.93 / $170.52	Professional	52	$88.93	$88.93	$170.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $209.51 / $376.03 / $451.38	Professional		$209.51	$376.03	$451.38
United Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $3,218.00 / $5,272.00	Facility		$607.00	$3,218.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $248.32 / $395.27 / $609.70	Professional		$248.32	$395.27	$609.70