Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $535.13 / $2,950.00 / $6,726.00	Facility		$535.13	$2,950.00	$6,726.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $127.83 / $361.77 / $563.36	Facility	52	$127.83	$361.77	$563.36
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.13 / $144.71 / $225.34	Facility	53	$51.13	$144.71	$225.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.65 / $617.59 / $1,306.92	Professional		$255.65	$617.59	$1,306.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $252.55 / $348.75 / $459.39	Professional		$252.55	$348.75	$459.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $568.00 / $2,111.58 / $4,819.75	Facility		$568.00	$2,111.58	$4,819.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $273.74 / $469.56 / $779.93	Professional		$273.74	$469.56	$779.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $930.47 / $930.47 / $930.47	Facility		$930.47	$930.47	$930.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $235.11 / $235.11 / $235.11	Professional		$235.11	$235.11	$235.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.00 / $716.39 / $2,880.00	Facility		$453.00	$716.39	$2,880.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $642.41 / $1,410.00	Professional		$334.68	$642.41	$1,410.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.95 / $721.99 / $1,128.16	Professional		$286.95	$721.99	$1,128.16
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $701.02 / $894.83 / $1,763.75	Professional	22	$701.02	$894.83	$1,763.75
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $204.46 / $260.99 / $514.42	Professional	52	$204.46	$260.99	$514.42
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $204.46 / $260.99 / $514.42	Professional	53	$204.46	$260.99	$514.42
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,178.87 / $3,750.00 / $3,750.00	Facility		$2,178.87	$3,750.00	$3,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $313.17 / $661.88 / $1,233.28	Professional		$313.17	$661.88	$1,233.28
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 $633.76 / $897.17 / $1,551.17	Professional		$633.76	$897.17	$1,551.17