Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.03 / $3,622.80 / $6,915.00	Facility		$202.03	$3,622.80	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $219.12 / $422.24	Professional		$131.38	$219.12	$422.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.64 / $123.64 / $166.92	Professional		$123.64	$123.64	$166.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,098.00 / $3,851.83	Facility		$759.49	$2,098.00	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.11 / $258.07 / $444.11	Professional		$170.11	$258.07	$444.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $145.46 / $181.24 / $565.11	Facility		$145.46	$181.24	$565.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $212.58 / $249.50 / $260.93	Professional		$212.58	$249.50	$260.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.47 / $242.48 / $444.73	Professional		$140.47	$242.48	$444.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.13 / $249.50 / $390.85	Professional		$166.13	$249.50	$390.85
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $304.50 / $304.50 / $457.30	Professional	22	$304.50	$304.50	$457.30
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,750.00 / $1,750.00 / $1,750.00	Facility		$1,750.00	$1,750.00	$1,750.00
United Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,550.00 / $2,665.00	Facility		$450.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $215.39 / $332.41 / $519.49	Professional		$215.39	$332.41	$519.49