Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $932.00 / $3,391.00 / $6,915.00	Facility		$932.00	$3,391.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $690.21 / $703.65 / $976.04	Facility	54	$690.21	$703.65	$976.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $636.28 / $938.20 / $1,620.88	Professional		$636.28	$938.20	$1,620.88
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $119.62 / $147.60 / $203.18	Professional	55	$119.62	$147.60	$203.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $714.24 / $970.00 / $1,400.70	Professional		$714.24	$970.00	$1,400.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $606.69 / $3,392.46 / $8,094.63	Facility		$606.69	$3,392.46	$8,094.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $708.70 / $1,070.66 / $1,996.42	Professional		$708.70	$1,070.66	$1,996.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,351.35 / $1,658.73 / $74,999.25	Facility		$1,351.35	$1,658.73	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.00 / $2,285.73 / $2,878.34	Facility		$411.00	$2,285.73	$2,878.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $698.84 / $1,025.52 / $2,001.36	Professional		$698.84	$1,025.52	$2,001.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $866.20 / $1,259.92 / $6,376.24	Professional		$866.20	$1,259.92	$6,376.24
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $971.63 / $971.63 / $971.63	Professional	54	$971.63	$971.63	$971.63
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $69.40 / $69.40 / $69.40	Professional	55	$69.40	$69.40	$69.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,363.12 / $2,363.12 / $4,875.00	Facility		$2,363.12	$2,363.12	$4,875.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,031.56 / $1,231.67 / $1,574.90	Professional		$1,031.56	$1,231.67	$1,574.90
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 $721.57 / $961.86 / $1,714.93	Professional		$721.57	$961.86	$1,714.93