Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.00 / $2,460.60 / $5,917.00	Facility		$248.00	$2,460.60	$5,917.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.47 / $119.00 / $152.86	Facility	52	$35.47	$119.00	$152.86
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $14.19 / $47.60 / $61.14	Facility	53	$14.19	$47.60	$61.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $181.57 / $582.54	Professional		$70.95	$181.57	$582.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $94.57 / $125.41	Professional		$62.71	$94.57	$125.41
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 $90.15 / $213.87 / $516.15	Professional		$90.15	$213.87	$516.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.77 / $94.57 / $113.23	Facility		$70.77	$94.57	$113.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.77 / $314.29 / $400.69	Professional		$245.77	$314.29	$400.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.00 / $546.00 / $2,880.00	Facility		$338.00	$546.00	$2,880.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $197.11 / $556.76	Professional		$86.98	$197.11	$556.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.39 / $272.01 / $459.70	Professional		$81.39	$272.01	$459.70
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $57.99 / $74.02 / $222.88	Professional	52	$57.99	$74.02	$222.88
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $57.99 / $74.02 / $222.88	Professional	53	$57.99	$74.02	$222.88
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 $71.34 / $258.41 / $596.99	Professional		$71.34	$258.41	$596.99
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 $187.92 / $293.37 / $586.03	Professional		$187.92	$293.37	$586.03