Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.54 / $1,791.00 / $6,915.00	Facility		$53.54	$1,791.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $103.47 / $198.89	Professional		$45.71	$103.47	$198.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.29 / $160.10 / $215.90	Professional		$116.29	$160.10	$215.90
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 $52.86 / $100.54 / $222.60	Professional		$52.86	$100.54	$222.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $48.17 / $60.22 / $194.15	Facility		$48.17	$60.22	$194.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.73 / $127.92 / $134.90	Professional		$106.73	$127.92	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $94.04 / $228.01	Professional		$44.32	$94.04	$228.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $127.92 / $139.58	Professional		$55.20	$127.92	$139.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $117.40 / $193.12	Professional		$55.20	$117.40	$193.12
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 $77.33 / $124.32 / $265.07	Professional		$77.33	$124.32	$265.07