Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.66 / $2,783.65 / $5,063.00	Facility		$275.66	$2,783.65	$5,063.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.23 / $42.82 / $57.61	Facility	53	$20.23	$42.82	$57.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $223.81 / $533.41	Professional		$94.12	$223.81	$533.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.51 / $184.66 / $458.51	Professional		$125.51	$184.66	$458.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,139.92 / $4,143.39	Facility		$741.08	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.58 / $149.66 / $288.83	Professional		$97.58	$149.66	$288.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.71 / $134.81 / $199.89	Facility		$102.71	$134.81	$199.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $229.69 / $290.95 / $313.33	Professional		$229.69	$290.95	$313.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.56 / $168.56 / $1,150.00	Facility		$168.56	$168.56	$1,150.00
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.71 / $33.71 / $33.71	Facility	53	$33.71	$33.71	$33.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $250.67 / $580.40	Professional		$124.64	$250.67	$580.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.02 / $293.89 / $2,004.00	Professional		$116.02	$293.89	$2,004.00
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $97.85 / $97.85 / $249.97	Professional	53	$97.85	$97.85	$249.97
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,625.05 / $1,625.05 / $2,150.00	Facility		$1,625.05	$1,625.05	$2,150.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $237.37 / $480.88	Professional		$101.09	$237.37	$480.88
United Facility/Professional Facility Modifier Low / Median / High Price $426.00 / $2,360.00 / $4,066.00	Facility		$426.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.63 / $360.43 / $657.84	Professional		$223.63	$360.43	$657.84