Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $974.46 / $3,826.00 / $6,915.00	Facility		$974.46	$3,826.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,687.00 / $1,687.00 / $1,687.00	Facility	50	$1,687.00	$1,687.00	$1,687.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $103.51 / $208.40 / $487.23	Facility	52	$103.51	$208.40	$487.23
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.40 / $83.36 / $194.89	Facility	53	$41.40	$83.36	$194.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.02 / $837.89 / $2,026.47	Professional		$207.02	$837.89	$2,026.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.93 / $189.93 / $189.93	Professional		$189.93	$189.93	$189.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $996.37 / $2,722.51 / $5,292.58	Facility		$996.37	$2,722.51	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.58 / $723.18 / $1,642.90	Professional		$261.58	$723.18	$1,642.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $373.97 / $411.83 / $632.46	Facility		$373.97	$411.83	$632.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,212.51 / $1,212.51 / $1,212.51	Facility		$1,212.51	$1,212.51	$1,212.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.92 / $627.82 / $1,907.04	Professional		$278.92	$627.82	$1,907.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.29 / $927.82 / $3,986.00	Professional		$225.29	$927.82	$3,986.00
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $140.69 / $140.69 / $605.76	Professional	52	$140.69	$140.69	$605.76
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $140.69 / $140.69 / $605.76	Professional	53	$140.69	$140.69	$605.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $4,826.00 / $7,889.00	Facility		$1,200.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $893.68 / $1,269.72 / $2,119.53	Professional		$893.68	$1,269.72	$2,119.53