Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $6,918.31 / $10,964.78	Facility		$4,168.69	$6,918.31	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $831.76 / $1,412.54	Professional		$616.60	$831.76	$1,412.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,148.15 / $3,019.95	Professional		$758.58	$1,148.15	$3,019.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,801.89 / $6,918.31	Facility		$1,479.11	$3,801.89	$6,918.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $676.08 / $1,047.13	Professional		$660.69	$676.08	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $4,073.80 / $5,128.61	Facility		$776.25	$4,073.80	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,023.29 / $1,778.28	Professional		$630.96	$1,023.29	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $831.76 / $4,466.84	Professional		$645.65	$831.76	$4,466.84
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,737.80 / $1,737.80 / $2,691.53	Professional	22	$1,737.80	$1,737.80	$2,691.53
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $512.86 / $794.33 / $1,023.29	Professional	53	$512.86	$794.33	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $812.83 / $812.83 / $1,258.93	Professional	54	$812.83	$812.83	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $57.54 / $57.54 / $89.13	Professional	55	$57.54	$57.54	$89.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $870.96 / $1,096.48	Professional		$776.25	$870.96	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $6,309.57 / $12,022.64	Facility		$1,258.93	$6,309.57	$12,022.64
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $977.24 / $1,548.82	Professional		$676.08	$977.24	$1,548.82