Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.02 / $4,590.00 / $6,915.00	Facility		$57.02	$4,590.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $117.37 / $206.84	Professional		$55.86	$117.37	$206.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.31 / $175.00 / $251.87	Professional		$109.31	$175.00	$251.87
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 $63.16 / $118.13 / $251.24	Professional		$63.16	$118.13	$251.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.04 / $70.01 / $228.48	Facility		$56.04	$70.01	$228.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.16 / $145.06 / $152.91	Professional		$121.16	$145.06	$152.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $110.94 / $259.33	Professional		$54.52	$110.94	$259.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.17 / $145.06 / $177.65	Professional		$64.17	$145.06	$177.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.17 / $133.28 / $219.34	Professional		$64.17	$133.28	$219.34
United Facility/Professional Facility Modifier Low / Median / High Price $389.00 / $1,570.00 / $2,665.00	Facility		$389.00	$1,570.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $159.13 / $303.01	Professional		$115.20	$159.13	$303.01