Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.29 / $1,791.00 / $6,915.00	Facility		$62.29	$1,791.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.39 / $103.65 / $217.11	Professional		$46.39	$103.65	$217.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.85 / $216.94 / $223.18	Professional		$116.85	$216.94	$223.18
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 $54.51 / $101.70 / $224.35	Professional		$54.51	$101.70	$224.35
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $81.76 / $152.55 / $336.52	Professional	50	$81.76	$152.55	$336.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.67 / $56.63 / $189.00	Facility		$45.67	$56.63	$189.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.37 / $128.54 / $136.19	Professional		$107.37	$128.54	$136.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $92.36 / $230.74	Professional		$48.60	$92.36	$230.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $128.54 / $156.11	Professional		$51.91	$128.54	$156.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $118.11 / $192.89	Professional		$51.91	$118.11	$192.89
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 $101.05 / $136.59 / $267.62	Professional		$101.05	$136.59	$267.62