Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $831.76 / $1,023.29	Facility		$416.87	$831.76	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $501.19	Professional		$416.87	$416.87	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $263.03 / $741.31	Professional		$19.05	$263.03	$741.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $457.09 / $616.60	Facility		$165.96	$457.09	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $537.03	Professional		$165.96	$165.96	$537.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $588.84 / $891.25	Facility		$501.19	$588.84	$891.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $537.03 / $562.34	Professional		$501.19	$537.03	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $912.01 / $1,258.93	Facility		$645.65	$912.01	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $1,000.00 / $2,344.23	Professional		$208.93	$1,000.00	$2,344.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $537.03 / $3,235.94	Professional		$371.54	$537.03	$3,235.94
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $3,890.45	Facility		$1,288.25	$1,288.25	$3,890.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $512.86 / $891.25	Professional		$416.87	$512.86	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $416.87	Facility		$371.54	$371.54	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $616.60	Professional		$173.78	$251.19	$616.60