Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $2,884.03 / $7,079.46	Facility		$371.54	$2,884.03	$7,079.46
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $245.47 / $1,445.44 / $2,290.87	Facility	52	$245.47	$1,445.44	$2,290.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $91.20 / $173.78 / $2,089.30	Facility	53	$91.20	$173.78	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $363.08 / $851.14	Professional		$177.83	$363.08	$851.14
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $85.11 / $162.18 / $302.00	Professional	53	$85.11	$162.18	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $338.84	Professional		$158.49	$213.80	$338.84
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $52.48 / $95.50 / $154.88	Professional	53	$52.48	$95.50	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,737.80 / $3,467.37	Facility		$741.31	$1,737.80	$3,467.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $645.65	Professional		$229.09	$371.54	$645.65
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $91.20 / $169.82 / $173.78	Professional	53	$91.20	$169.82	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $186.21 / $295.12	Facility		$33.88	$186.21	$295.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $169.82 / $478.63	Professional		$39.81	$169.82	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $616.60 / $2,691.53	Facility		$501.19	$616.60	$2,691.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $380.19 / $691.83	Professional		$223.87	$380.19	$691.83
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $67.61 / $208.93 / $1,023.29	Professional	53	$67.61	$208.93	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $831.76	Professional		$194.98	$426.58	$831.76
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $501.19 / $645.65 / $1,174.90	Professional	22	$501.19	$645.65	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $147.91 / $186.21 / $346.74	Professional	52	$147.91	$186.21	$346.74
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $97.72 / $190.55 / $338.84	Professional	53	$97.72	$190.55	$338.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $4,265.80 / $4,265.80	Facility		$1,862.09	$4,265.80	$4,265.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $295.12 / $741.31	Professional		$131.83	$295.12	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $2,454.71 / $5,248.07	Facility		$512.86	$2,454.71	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $645.65	Professional		$194.98	$346.74	$645.65
United Facility/Professional Professional Modifier 53 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	53	$218.78	$218.78	$218.78