Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.97 / $3,306.00 / $6,915.00	Facility		$31.97	$3,306.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.73 / $75.22 / $165.01	Professional		$28.73	$75.22	$165.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $95.45 / $177.21	Professional		$30.17	$95.45	$177.21
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 $33.33 / $73.52 / $179.10	Professional		$33.33	$73.52	$179.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.59 / $39.46 / $128.16	Facility		$31.59	$39.46	$128.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $105.00 / $110.80	Professional		$87.00	$105.00	$110.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.24 / $65.63 / $188.11	Professional		$28.24	$65.63	$188.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $97.69 / $113.10	Professional		$36.17	$97.69	$113.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $95.70 / $156.99	Professional		$36.17	$95.70	$156.99
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 $76.08 / $109.88 / $219.17	Professional		$76.08	$109.88	$219.17