Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $559.01 / $2,888.00 / $6,715.80	Facility		$559.01	$2,888.00	$6,715.80
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.88 / $34.79 / $58.54	Facility	52	$30.88	$34.79	$58.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $129.07 / $258.30	Professional		$66.04	$129.07	$258.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.33 / $169.04 / $229.22	Professional		$98.33	$169.04	$229.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.15 / $132.38 / $229.04	Professional		$78.15	$132.38	$229.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.80 / $96.26 / $106.58	Facility		$70.80	$96.26	$106.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.13 / $160.88 / $278.70	Professional		$159.13	$160.88	$278.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $476.98 / $476.98 / $476.98	Facility		$476.98	$476.98	$476.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.89 / $167.16 / $286.68	Professional		$94.89	$167.16	$286.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.88 / $142.44 / $540.00	Professional		$77.88	$142.44	$540.00
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $41.63 / $41.63 / $76.14	Professional	52	$41.63	$41.63	$76.14
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,306.75 / $3,425.00 / $5,938.87	Facility		$1,306.75	$3,425.00	$5,938.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.32 / $195.54 / $239.57	Professional		$106.32	$195.54	$239.57
United Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $2,360.00 / $4,066.00	Facility		$424.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $132.28 / $188.60 / $293.24	Professional		$132.28	$188.60	$293.24