Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.81 / $2,171.00 / $5,063.00	Facility		$190.81	$2,171.00	$5,063.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $27.50 / $101.15 / $1,607.00	Facility	52	$27.50	$101.15	$1,607.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.00 / $38.15 / $1,319.39	Facility	53	$11.00	$38.15	$1,319.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $138.43 / $364.13	Professional		$54.99	$138.43	$364.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $87.73 / $333.21	Professional		$50.39	$87.73	$333.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,729.39 / $3,784.98	Facility		$450.00	$1,729.39	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.40 / $165.60 / $366.45	Professional		$71.40	$165.60	$366.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.78 / $74.26 / $89.25	Facility		$55.78	$74.26	$89.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $163.29 / $208.00 / $265.97	Professional		$163.29	$208.00	$265.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.40 / $412.36 / $2,880.00	Facility		$168.40	$412.36	$2,880.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $157.77 / $375.64	Professional		$69.41	$157.77	$375.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.15 / $180.26 / $304.64	Professional		$64.15	$180.26	$304.64
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $45.71 / $58.34 / $147.71	Professional	52	$45.71	$58.34	$147.71
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $45.71 / $58.34 / $147.71	Professional	53	$45.71	$58.34	$147.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,625.05 / $2,150.00 / $2,150.00	Facility		$1,625.05	$2,150.00	$2,150.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.33 / $189.84 / $351.86	Professional		$60.33	$189.84	$351.86
United Facility/Professional Facility Modifier Low / Median / High Price $394.00 / $1,952.00 / $4,066.00	Facility		$394.00	$1,952.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $146.50 / $206.33 / $372.74	Professional		$146.50	$206.33	$372.74