Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.96 / $754.50 / $5,045.00	Facility		$52.96	$754.50	$5,045.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $12.77 / $32.82 / $72.73	Facility	52	$12.77	$32.82	$72.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.54 / $60.58 / $148.38	Professional		$25.54	$60.58	$148.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.76 / $30.92 / $73.89	Professional	52	$12.76	$30.92	$73.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $89.64 / $111.25	Professional		$29.28	$89.64	$111.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $68.94 / $147.41	Professional		$32.97	$68.94	$147.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.12 / $32.79 / $36.29	Facility		$24.12	$32.79	$36.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $73.62 / $126.54	Professional		$73.00	$73.62	$126.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $75.09 / $165.35	Professional		$34.15	$75.09	$165.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $65.91 / $230.78	Professional		$27.74	$65.91	$230.78
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $17.32 / $17.32 / $43.04	Professional	52	$17.32	$17.32	$43.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $40.04 / $110.77	Professional		$37.72	$40.04	$110.77
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.70 / $103.82 / $163.07	Professional		$62.70	$103.82	$163.07