Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $2,398.83 / $5,888.44	Facility		$691.83	$2,398.83	$5,888.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility	50	$3,019.95	$3,019.95	$3,019.95
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	52	$1,380.38	$1,380.38	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $239.88 / $645.65	Professional		$102.33	$239.88	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $346.74	Professional		$93.33	$141.25	$346.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,238.72 / $3,548.13	Facility		$794.33	$2,238.72	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $309.03 / $977.24	Professional		$151.36	$309.03	$977.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $147.91 / $208.93	Facility		$128.82	$147.91	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $645.65	Professional		$363.08	$363.08	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $295.12 / $812.83	Professional		$147.91	$295.12	$812.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $316.23 / $537.03	Professional		$95.50	$316.23	$537.03
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $72.44 / $72.44 / $208.93	Professional	52	$72.44	$72.44	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $72.44 / $72.44 / $208.93	Professional	53	$72.44	$72.44	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,187.76 / $3,467.37	Facility		$426.58	$2,187.76	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $295.12 / $933.25	Professional		$117.49	$295.12	$933.25