Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.99 / $2,715.37 / $5,397.91	Facility		$549.99	$2,715.37	$5,397.91
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $52.35 / $154.56 / $1,176.00	Facility	52	$52.35	$154.56	$1,176.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.94 / $43.23 / $110.00	Facility	53	$20.94	$43.23	$110.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.44 / $275.97 / $617.65	Professional		$102.44	$275.97	$617.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $173.43 / $519.42	Professional		$101.09	$173.43	$519.42
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 $136.87 / $307.83 / $625.50	Professional		$136.87	$307.83	$625.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.63 / $138.74 / $164.90	Facility		$102.63	$138.74	$164.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $253.91 / $322.26 / $413.87	Professional		$253.91	$322.26	$413.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.00 / $575.79 / $788.49	Facility		$338.00	$575.79	$788.49
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.57 / $267.58 / $635.29	Professional		$134.57	$267.58	$635.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.02 / $277.42 / $699.10	Professional		$118.02	$277.42	$699.10
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $84.09 / $107.34 / $227.31	Professional	52	$84.09	$107.34	$227.31
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $84.09 / $107.34 / $227.31	Professional	53	$84.09	$107.34	$227.31
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $143.54 / $1,673.72 / $2,150.00	Facility		$143.54	$1,673.72	$2,150.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.66 / $292.00 / $790.77	Professional		$101.66	$292.00	$790.77
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 $282.70 / $437.01 / $711.48	Professional		$282.70	$437.01	$711.48