Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.75 / $1,695.50 / $5,063.00	Facility		$59.75	$1,695.50	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.04 / $59.75 / $117.33	Professional		$43.04	$59.75	$117.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.28 / $103.93 / $111.87	Professional		$59.28	$103.93	$111.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $7,875.00 / $7,875.00	Facility		$7,875.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.57 / $68.06 / $115.44	Professional		$50.57	$68.06	$115.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.25 / $65.58 / $72.59	Facility		$48.25	$65.58	$72.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $74.47 / $130.25	Professional		$73.22	$74.47	$130.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.21 / $96.44 / $134.31	Professional		$63.21	$96.44	$134.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $70.28 / $251.00	Professional		$53.08	$70.28	$251.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $89.26 / $108.35	Professional		$73.22	$89.26	$108.35
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $87.83 / $134.13	Professional		$61.30	$87.83	$134.13