Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.95 / $4,590.00 / $6,915.00	Facility		$59.95	$4,590.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $117.15 / $231.48	Professional		$57.00	$117.15	$231.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.46 / $176.07 / $231.93	Professional		$112.46	$176.07	$231.93
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 $64.80 / $116.84 / $236.15	Professional		$64.80	$116.84	$236.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $73.55 / $238.56	Facility		$58.88	$73.55	$238.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.43 / $145.10 / $152.90	Professional		$121.43	$145.10	$152.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.88 / $107.70 / $256.25	Professional		$54.88	$107.70	$256.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.42 / $145.10 / $174.19	Professional		$67.42	$145.10	$174.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.42 / $133.57 / $220.62	Professional		$67.42	$133.57	$220.62
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 $110.76 / $147.16 / $312.97	Professional		$110.76	$147.16	$312.97