Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $341.86 / $3,214.00 / $6,915.00	Facility		$341.86	$3,214.00	$6,915.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $199.07 / $298.16 / $471.34	Facility	54	$199.07	$298.16	$471.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.69 / $319.14 / $656.29	Professional		$236.69	$319.14	$656.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,081.84 / $1,081.84 / $1,081.84	Professional	50	$1,081.84	$1,081.84	$1,081.84
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $175.65 / $228.14 / $471.34	Professional	54	$175.65	$228.14	$471.34
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $35.13 / $45.63 / $94.27	Professional	55	$35.13	$45.63	$94.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.51 / $370.99 / $509.56	Professional		$218.51	$370.99	$509.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $449.48 / $449.48 / $700.63	Professional	50	$449.48	$449.48	$700.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $606.69 / $2,085.16 / $3,851.83	Facility		$606.69	$2,085.16	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.83 / $345.14 / $633.51	Professional		$230.83	$345.14	$633.51
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $346.24 / $517.71 / $950.26	Professional	50	$346.24	$517.71	$950.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $226.69 / $317.37 / $847.49	Facility		$226.69	$317.37	$847.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.39 / $227.99 / $411.00	Facility		$182.39	$227.99	$411.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.25 / $460.07 / $764.97	Professional		$254.25	$460.07	$764.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $260.69 / $399.53 / $1,838.96	Professional		$260.69	$399.53	$1,838.96
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $279.70 / $279.70 / $352.14	Professional	54	$279.70	$279.70	$352.14
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $19.98 / $19.98 / $25.15	Professional	55	$19.98	$19.98	$25.15
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $273.74 / $396.71 / $627.05	Professional		$273.74	$396.71	$627.05
United Facility/Professional Facility Modifier Low / Median / High Price $410.00 / $2,300.00 / $4,066.00	Facility		$410.00	$2,300.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $297.20 / $437.57 / $717.43	Professional		$297.20	$437.57	$717.43