Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $473.69 / $3,083.04 / $5,595.00	Facility		$473.69	$3,083.04	$5,595.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $47.50 / $87.99 / $236.85	Facility	52	$47.50	$87.99	$236.85
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.00 / $35.20 / $94.74	Facility	53	$19.00	$35.20	$94.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.85 / $280.07 / $652.07	Professional		$83.85	$280.07	$652.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $321.37 / $659.06	Professional		$78.03	$321.37	$659.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $996.37 / $3,013.60 / $6,868.98	Facility		$996.37	$3,013.60	$6,868.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.13 / $299.64 / $740.38	Professional		$107.13	$299.64	$740.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.22 / $109.24 / $118.16	Facility		$80.22	$109.24	$118.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $427.86 / $429.89 / $733.43	Professional		$427.86	$429.89	$733.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,882.00 / $10,446.00 / $11,874.00	Facility		$5,882.00	$10,446.00	$11,874.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.37 / $258.08 / $844.14	Professional		$108.37	$258.08	$844.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.26 / $390.48 / $674.46	Professional		$96.26	$390.48	$674.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.65 / $154.82 / $688.16	Professional		$132.65	$154.82	$688.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,036.00 / $3,629.00 / $6,165.00	Facility		$1,036.00	$3,629.00	$6,165.00
United Facility/Professional Professional Modifier Low / Median / High Price $409.99 / $591.79 / $918.32	Professional		$409.99	$591.79	$918.32