Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.68 / $2,297.00 / $6,915.00	Facility		$179.68	$2,297.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $43.23 / $133.49 / $199.06	Facility	52	$43.23	$133.49	$199.06
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.29 / $53.40 / $79.63	Facility	53	$17.29	$53.40	$79.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.45 / $216.04 / $510.93	Professional		$86.45	$216.04	$510.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.67 / $163.34 / $163.34	Professional		$77.67	$163.34	$163.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,635.81 / $3,784.98	Facility		$450.00	$1,635.81	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $258.99 / $541.28	Professional		$115.20	$258.99	$541.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $424.00 / $424.00	Facility		$424.00	$424.00	$424.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.01 / $80.01 / $80.01	Professional		$80.01	$80.01	$80.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $334.00 / $535.00 / $652.00	Facility		$334.00	$535.00	$652.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.99 / $236.86 / $534.94	Professional		$111.99	$236.86	$534.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.35 / $257.61 / $431.55	Professional		$98.35	$257.61	$431.55
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $70.06 / $89.45 / $206.69	Professional	52	$70.06	$89.45	$206.69
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $70.06 / $89.45 / $206.69	Professional	53	$70.06	$89.45	$206.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.58 / $408.65 / $540.57	Professional		$132.58	$408.65	$540.57
United Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $2,307.00 / $5,272.00	Facility		$515.00	$2,307.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $220.68 / $323.26 / $530.95	Professional		$220.68	$323.26	$530.95