Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.42 / $699.00 / $6,726.00	Facility		$42.42	$699.00	$6,726.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.11 / $45.89 / $103.34	Professional		$15.11	$45.89	$103.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $16.87	Professional		$12.49	$12.49	$16.87
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 $17.46 / $42.74 / $118.88	Professional		$17.46	$42.74	$118.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $26.19 / $64.11 / $178.32	Professional	50	$26.19	$64.11	$178.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.70 / $18.00 / $58.21	Facility		$14.70	$18.00	$58.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $74.67 / $78.86	Professional		$61.54	$74.67	$78.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.97 / $40.47 / $133.10	Professional		$14.97	$40.47	$133.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $16.50 / $74.67 / $133.56	Professional		$16.50	$74.67	$133.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.50 / $64.09 / $108.95	Professional		$16.50	$64.09	$108.95
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 $48.18 / $67.90 / $155.11	Professional		$48.18	$67.90	$155.11