Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,703.65 / $6,014.00 / $9,650.50	Facility		$1,703.65	$6,014.00	$9,650.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $152.44 / $152.44 / $152.44	Facility	53	$152.44	$152.44	$152.44
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $571.64 / $571.64 / $571.64	Facility	54	$571.64	$571.64	$571.64
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $114.33 / $114.33 / $114.33	Facility	55	$114.33	$114.33	$114.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $609.66 / $762.19 / $1,271.04	Professional		$609.66	$762.19	$1,271.04
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $98.21 / $114.33 / $129.53	Professional	55	$98.21	$114.33	$129.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $658.57 / $930.45 / $1,222.70	Professional		$658.57	$930.45	$1,222.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,269.29 / $3,859.05 / $8,545.91	Facility		$1,269.29	$3,859.05	$8,545.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $665.50 / $680.53 / $1,601.80	Professional		$665.50	$680.53	$1,601.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.00 / $4,103.31 / $5,167.14	Facility		$778.00	$4,103.31	$5,167.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $657.11 / $1,027.83 / $1,760.25	Professional		$657.11	$1,027.83	$1,760.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.43 / $922.00 / $4,501.00	Professional		$724.43	$922.00	$4,501.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,741.31 / $1,741.31 / $1,741.31	Professional	22	$1,741.31	$1,741.31	$1,741.31
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $507.88 / $507.88 / $507.88	Professional	53	$507.88	$507.88	$507.88
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $812.61 / $812.61 / $812.61	Professional	54	$812.61	$812.61	$812.61
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $58.04 / $58.04 / $58.04	Professional	55	$58.04	$58.04	$58.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $794.70 / $978.10 / $1,317.14	Professional		$794.70	$978.10	$1,317.14
United Facility/Professional Facility Modifier Low / Median / High Price $1,500.00 / $7,230.00 / $11,889.00	Facility		$1,500.00	$7,230.00	$11,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $691.39 / $1,015.29 / $1,569.24	Professional		$691.39	$1,015.29	$1,569.24