Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.52 / $2,987.00 / $6,915.00	Facility		$45.52	$2,987.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $50.95 / $120.52	Professional		$21.03	$50.95	$120.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.42 / $66.03 / $84.37	Professional		$37.42	$66.03	$84.37
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 $23.81 / $49.50 / $90.50	Professional		$23.81	$49.50	$90.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.32 / $25.40 / $66.98	Facility		$20.32	$25.40	$66.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.02 / $52.73 / $55.66	Professional		$44.02	$52.73	$55.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.93 / $43.03 / $95.17	Professional		$19.93	$43.03	$95.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.29 / $44.02 / $67.12	Professional		$23.29	$44.02	$67.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.29 / $45.23 / $79.09	Professional		$23.29	$45.23	$79.09
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 $46.33 / $71.53 / $114.58	Professional		$46.33	$71.53	$114.58