Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $2,511.89 / $6,309.57	Facility		$331.13	$2,511.89	$6,309.57
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,819.70 / $2,089.30 / $16,595.87	Facility	52	$1,819.70	$2,089.30	$16,595.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility	53	$2,454.71	$2,454.71	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $263.03 / $676.08	Professional		$112.20	$263.03	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $218.78	Professional		$85.11	$141.25	$218.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,584.89 / $3,467.37	Facility		$588.84	$1,584.89	$3,467.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $331.13 / $575.44	Professional		$177.83	$331.13	$575.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $169.82 / $229.09	Facility		$138.04	$169.82	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $398.11	Professional		$251.19	$316.23	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $537.03 / $776.25	Facility		$338.84	$537.03	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $295.12 / $562.34	Professional		$147.91	$295.12	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $331.13 / $630.96	Professional		$128.82	$331.13	$630.96
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $331.13 / $426.58 / $1,000.00	Professional	22	$331.13	$426.58	$1,000.00
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $97.72 / $125.89 / $288.40	Professional	52	$97.72	$125.89	$288.40
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $97.72 / $125.89 / $380.19	Professional	53	$97.72	$125.89	$380.19
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $9,120.11 / $9,120.11	Facility		$2,511.89	$9,120.11	$9,120.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $309.03 / $676.08	Professional		$117.49	$309.03	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,454.71 / $5,248.07	Facility		$524.81	$2,454.71	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $269.15 / $512.86	Professional		$128.82	$269.15	$512.86