Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $427.39 / $3,391.00 / $6,915.00	Facility		$427.39	$3,391.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,640.00 / $3,640.00 / $3,640.00	Facility	50	$3,640.00	$3,640.00	$3,640.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $3,857.40 / $3,857.40 / $3,857.40	Facility	52	$3,857.40	$3,857.40	$3,857.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.37 / $319.98 / $471.96	Professional		$139.37	$319.98	$471.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,634.62 / $5,292.58	Facility		$964.00	$2,634.62	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.57 / $221.13 / $414.91	Professional		$143.57	$221.13	$414.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $215.35 / $331.69 / $622.37	Professional	50	$215.35	$331.69	$622.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $188.84 / $302.14 / $435.45	Facility		$188.84	$302.14	$435.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $248.99 / $248.99 / $1,272.50	Facility		$248.99	$248.99	$1,272.50
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $199.19 / $199.19 / $199.19	Facility	52	$199.19	$199.19	$199.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.02 / $375.08 / $878.80	Professional		$183.02	$375.08	$878.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $172.13 / $440.15 / $1,072.33	Professional		$172.13	$440.15	$1,072.33
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $145.19 / $145.19 / $375.32	Professional	52	$145.19	$145.19	$375.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $220.80 / $549.91 / $685.98	Professional		$220.80	$549.91	$685.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $4,826.00 / $7,889.00	Facility		$1,075.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $354.93 / $574.00 / $973.75	Professional		$354.93	$574.00	$973.75