Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $786.37 / $2,987.00 / $6,915.00	Facility		$786.37	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $507.59 / $589.78 / $859.44	Facility	54	$507.59	$589.78	$859.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $530.07 / $751.71 / $1,414.47	Professional		$530.07	$751.71	$1,414.47
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $441.83 / $572.27 / $886.27	Professional	54	$441.83	$572.27	$886.27
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $88.37 / $114.45 / $177.25	Professional	55	$88.37	$114.45	$177.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $305.97 / $933.05 / $1,227.34	Professional		$305.97	$933.05	$1,227.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $606.69 / $2,262.42 / $5,084.83	Facility		$606.69	$2,262.42	$5,084.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $557.42 / $783.75 / $1,460.56	Professional		$557.42	$783.75	$1,460.56
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $836.14 / $1,175.61 / $2,190.84	Professional	50	$836.14	$1,175.61	$2,190.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,006.97 / $1,227.61 / $74,999.25	Facility		$1,006.97	$1,227.61	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.00 / $541.29 / $681.64	Facility		$411.00	$541.29	$681.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $572.79 / $834.89 / $1,601.06	Professional		$572.79	$834.89	$1,601.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $670.21 / $932.46 / $4,689.06	Professional		$670.21	$932.46	$4,689.06
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $719.12 / $719.12 / $824.57	Professional	54	$719.12	$719.12	$824.57
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $51.37 / $51.37 / $58.90	Professional	55	$51.37	$51.37	$58.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $869.42 / $1,074.21 / $2,092.48	Professional		$869.42	$1,074.21	$2,092.48
United Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $3,100.00 / $5,272.00	Facility		$510.00	$3,100.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $629.30 / $829.03 / $1,487.93	Professional		$629.30	$829.03	$1,487.93