Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $766.50 / $4,852.00 / $8,155.00	Facility		$766.50	$4,852.00	$8,155.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $402.79 / $579.47 / $826.91	Facility	54	$402.79	$579.47	$826.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.35 / $673.02 / $1,235.65	Professional		$412.35	$673.02	$1,235.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $463.19 / $806.88 / $1,128.77	Professional		$463.19	$806.88	$1,128.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,805.30 / $5,084.83	Facility		$1,000.00	$2,805.30	$5,084.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.49 / $630.67 / $1,159.36	Professional		$467.49	$630.67	$1,159.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $801.02 / $975.68 / $74,999.25	Facility		$801.02	$975.68	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $886.00 / $1,119.77 / $1,410.08	Facility		$886.00	$1,119.77	$1,410.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $486.27 / $780.40 / $1,466.09	Professional		$486.27	$780.40	$1,466.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $532.66 / $832.31 / $3,721.00	Professional		$532.66	$832.31	$3,721.00
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $571.53 / $571.53 / $789.99	Professional	54	$571.53	$571.53	$789.99
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,560.50 / $1,560.50 / $1,560.50	Facility		$1,560.50	$1,560.50	$1,560.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $606.77 / $857.53 / $1,279.55	Professional		$606.77	$857.53	$1,279.55
United Facility/Professional Facility Modifier Low / Median / High Price $1,180.00 / $4,581.00 / $7,647.00	Facility		$1,180.00	$4,581.00	$7,647.00
United Facility/Professional Professional Modifier Low / Median / High Price $625.20 / $840.26 / $1,439.49	Professional		$625.20	$840.26	$1,439.49