Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.85 / $2,595.00 / $6,915.00	Facility		$59.85	$2,595.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $94.04 / $192.04	Professional		$36.61	$94.04	$192.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $113.76 / $172.64	Professional		$75.73	$113.76	$172.64
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 $41.15 / $90.17 / $175.65	Professional		$41.15	$90.17	$175.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.96 / $43.73 / $144.66	Facility		$34.96	$43.73	$144.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.51 / $105.36 / $111.36	Professional		$87.51	$105.36	$111.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.35 / $78.80 / $190.09	Professional		$34.35	$78.80	$190.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.08 / $87.51 / $113.76	Professional		$40.08	$87.51	$113.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.08 / $88.12 / $157.38	Professional		$40.08	$88.12	$157.38
United Facility/Professional Facility Modifier Low / Median / High Price $389.00 / $1,550.00 / $2,665.00	Facility		$389.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $133.03 / $219.36	Professional		$89.17	$133.03	$219.36