Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $422.68 / $2,357.00 / $6,726.00	Facility		$422.68	$2,357.00	$6,726.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $82.00 / $178.67 / $321.98	Facility	52	$82.00	$178.67	$321.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.16 / $364.56 / $779.39	Professional		$163.16	$364.56	$779.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.07 / $237.66 / $306.52	Professional		$135.07	$237.66	$306.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $542.00 / $1,729.39 / $3,784.98	Facility		$542.00	$1,729.39	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.86 / $393.64 / $799.79	Professional		$210.86	$393.64	$799.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $160.47 / $216.10 / $256.79	Facility		$160.47	$216.10	$256.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $360.86 / $455.76 / $587.40	Professional		$360.86	$455.76	$587.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $448.00 / $610.44 / $770.87	Facility		$448.00	$610.44	$770.87
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.71 / $367.98 / $841.57	Professional		$201.71	$367.98	$841.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.55 / $404.41 / $665.25	Professional		$184.55	$404.41	$665.25
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $131.49 / $167.85 / $322.55	Professional	52	$131.49	$167.85	$322.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.84 / $378.59 / $847.98	Professional		$168.84	$378.59	$847.98
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 $229.12 / $418.85 / $828.69	Professional		$229.12	$418.85	$828.69