Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.28 / $2,382.00 / $6,915.00	Facility		$242.28	$2,382.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.76 / $121.14 / $1,455.00	Facility	52	$18.76	$121.14	$1,455.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.85 / $175.52 / $419.88	Professional		$35.85	$175.52	$419.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $79.20 / $253.34	Professional		$36.00	$79.20	$253.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $1,729.39 / $3,784.98	Facility		$480.00	$1,729.39	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.86 / $183.72 / $457.24	Professional		$48.86	$183.72	$457.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $353.36 / $353.36 / $353.36	Facility		$353.36	$353.36	$353.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.19 / $35.19 / $35.19	Professional		$35.19	$35.19	$35.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.27 / $506.00 / $703.00	Facility		$143.27	$506.00	$703.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $51.42 / $51.42 / $51.42	Facility	52	$51.42	$51.42	$51.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.35 / $221.43 / $479.32	Professional		$47.35	$221.43	$479.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $212.59 / $635.28	Professional		$42.35	$212.59	$635.28
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $30.18 / $38.52 / $174.19	Professional	52	$30.18	$38.52	$174.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $259.44 / $453.23	Professional		$37.45	$259.44	$453.23
United Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $1,249.00 / $2,483.00	Facility		$105.00	$1,249.00	$2,483.00
United Facility/Professional Professional Modifier Low / Median / High Price $209.50 / $308.70 / $517.70	Professional		$209.50	$308.70	$517.70