Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $3,090.30 / $8,511.38	Facility		$446.68	$3,090.30	$8,511.38
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,096.48 / $1,096.48 / $1,122.02	Facility	52	$1,096.48	$1,096.48	$1,122.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility	53	$2,238.72	$2,238.72	$2,238.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $269.15 / $831.76	Professional		$66.07	$269.15	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $147.91 / $245.47	Professional		$85.11	$147.91	$245.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,819.70 / $3,467.37	Facility		$741.31	$1,819.70	$3,467.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $398.11 / $724.44	Professional		$204.17	$398.11	$724.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $190.55 / $257.04	Facility		$154.88	$190.55	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $407.38 / $512.86	Professional		$323.59	$407.38	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $616.60 / $794.33	Facility		$457.09	$616.60	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $354.81 / $691.83	Professional		$169.82	$354.81	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $426.58 / $812.83	Professional		$144.54	$426.58	$812.83
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $371.54 / $478.63 / $1,288.25	Professional	22	$371.54	$478.63	$1,288.25
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $109.65 / $141.25 / $371.54	Professional	52	$109.65	$141.25	$371.54
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $109.65 / $141.25 / $489.78	Professional	53	$109.65	$141.25	$489.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $398.11 / $851.14	Professional		$131.83	$398.11	$851.14
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 $144.54 / $338.84 / $660.69	Professional		$144.54	$338.84	$660.69