Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.29 / $3,391.00 / $6,915.00	Facility		$140.29	$3,391.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.84 / $55.08 / $123.38	Facility	52	$31.84	$55.08	$123.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.02 / $73.37 / $241.12	Professional		$59.02	$73.37	$241.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $115.57 / $233.91	Professional		$62.43	$115.57	$233.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.85 / $134.15 / $193.34	Facility		$83.85	$134.15	$193.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $72.65 / $657.54	Facility		$72.65	$72.65	$657.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $132.78 / $243.92	Professional		$77.84	$132.78	$243.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $107.64 / $318.93	Professional		$73.23	$107.64	$318.93
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $64.47 / $64.47 / $64.47	Professional	52	$64.47	$64.47	$64.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.69 / $101.13 / $117.82	Professional		$63.69	$101.13	$117.82
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 $58.54 / $113.13 / $208.08	Professional		$58.54	$113.13	$208.08