Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.22 / $3,164.00 / $6,915.00	Facility		$425.22	$3,164.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.09 / $770.78 / $1,791.83	Professional		$200.09	$770.78	$1,791.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $284.73 / $363.86 / $399.80	Professional		$284.73	$363.86	$399.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $572.89 / $2,155.98 / $4,875.60	Facility		$572.89	$2,155.98	$4,875.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $260.33 / $772.92 / $2,073.17	Professional		$260.33	$772.92	$2,073.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,691.11 / $1,691.11 / $1,691.11	Facility		$1,691.11	$1,691.11	$1,691.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $185.55 / $185.55 / $185.55	Professional		$185.55	$185.55	$185.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $343.38 / $546.00 / $1,233.00	Facility		$343.38	$546.00	$1,233.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $274.70 / $274.70 / $274.70	Facility	52	$274.70	$274.70	$274.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $68.68 / $68.68 / $68.68	Facility	53	$68.68	$68.68	$68.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.61 / $535.26 / $1,980.53	Professional		$256.61	$535.26	$1,980.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.38 / $772.92 / $1,947.76	Professional		$225.38	$772.92	$1,947.76
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $160.58 / $204.98 / $633.33	Professional	52	$160.58	$204.98	$633.33
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $160.58 / $204.98 / $633.33	Professional	53	$160.58	$204.98	$633.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.85 / $1,293.57 / $2,238.69	Professional		$194.85	$1,293.57	$2,238.69
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 $896.37 / $1,414.67 / $2,349.94	Professional		$896.37	$1,414.67	$2,349.94