Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,599.11 / $5,063.00 / $7,421.00	Facility		$1,599.11	$5,063.00	$7,421.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $792.59 / $792.59 / $1,236.65	Facility	54	$792.59	$792.59	$1,236.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $722.92 / $1,003.19 / $1,710.55	Professional		$722.92	$1,003.19	$1,710.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $465.92 / $567.11 / $1,060.55	Professional		$465.92	$567.11	$1,060.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,195.63 / $4,075.69 / $8,545.91	Facility		$1,195.63	$4,075.69	$8,545.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $609.51 / $1,221.93 / $1,702.78	Professional		$609.51	$1,221.93	$1,702.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,037.82 / $1,266.38 / $74,999.25	Facility		$1,037.82	$1,266.38	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.00 / $2,285.73 / $2,878.34	Facility		$778.00	$2,285.73	$2,878.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $745.12 / $1,419.85 / $2,128.46	Professional		$745.12	$1,419.85	$2,128.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $661.31 / $961.90 / $7,321.95	Professional		$661.31	$961.90	$7,321.95
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $741.80 / $741.80 / $741.80	Professional	54	$741.80	$741.80	$741.80
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $52.99 / $52.99 / $52.99	Professional	55	$52.99	$52.99	$52.99
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $42.39 / $42.39 / $42.39	Professional	80	$42.39	$42.39	$42.39
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,889.07 / $4,889.07 / $5,959.00	Facility		$4,889.07	$4,889.07	$5,959.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $780.18 / $787.55 / $895.77	Professional		$780.18	$787.55	$895.77
United Facility/Professional Facility Modifier Low / Median / High Price $1,250.00 / $7,299.00 / $11,889.00	Facility		$1,250.00	$7,299.00	$11,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $916.80 / $1,324.98 / $1,895.13	Professional		$916.80	$1,324.98	$1,895.13