Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $772.17 / $4,592.00 / $6,915.00	Facility		$772.17	$4,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $110.86 / $233.74 / $647.90	Facility	52	$110.86	$233.74	$647.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.72 / $654.83 / $1,544.98	Professional		$218.72	$654.83	$1,544.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $216.97 / $384.04 / $1,297.85	Professional		$216.97	$384.04	$1,297.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $572.89 / $2,155.98 / $4,875.60	Facility		$572.89	$2,155.98	$4,875.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $290.20 / $672.85 / $1,490.41	Professional		$290.20	$672.85	$1,490.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $870.35 / $870.35 / $870.35	Facility		$870.35	$870.35	$870.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $204.33 / $204.33 / $204.33	Professional		$204.33	$204.33	$204.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.00 / $703.00 / $1,449.18	Facility		$506.00	$703.00	$1,449.18
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.61 / $568.59 / $1,524.88	Professional		$285.61	$568.59	$1,524.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $249.52 / $684.26 / $1,755.54	Professional		$249.52	$684.26	$1,755.54
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $177.78 / $226.93 / $560.67	Professional	52	$177.78	$226.93	$560.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $319.24 / $975.10 / $2,064.40	Professional		$319.24	$975.10	$2,064.40
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 $660.98 / $989.83 / $1,654.34	Professional		$660.98	$989.83	$1,654.34