Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.78 / $2,221.00 / $6,726.00	Facility		$148.78	$2,221.00	$6,726.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.59 / $61.93 / $100.34	Facility	52	$40.59	$61.93	$100.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.55 / $123.86 / $258.23	Professional		$82.55	$123.86	$258.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.01 / $120.01 / $120.01	Professional		$120.01	$120.01	$120.01
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 $95.81 / $139.57 / $259.56	Professional		$95.81	$139.57	$259.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.67 / $114.35 / $344.26	Facility		$89.67	$114.35	$344.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.66 / $139.58 / $146.88	Professional		$117.66	$139.58	$146.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.07 / $145.41 / $278.14	Professional		$99.07	$145.41	$278.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.82 / $139.58 / $160.09	Professional		$104.82	$139.58	$160.09
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $56.03 / $56.03 / $74.62	Professional	52	$56.03	$56.03	$74.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.99 / $176.29 / $248.20	Professional		$148.99	$176.29	$248.20
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $115.24 / $160.66 / $327.05	Professional		$115.24	$160.66	$327.05