Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.83 / $3,460.00 / $6,915.00	Facility		$138.83	$3,460.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $142.84 / $286.69	Professional		$85.53	$142.84	$286.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.28 / $157.05 / $295.99	Professional		$122.28	$157.05	$295.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,080.80 / $3,851.83	Facility		$734.14	$2,080.80	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.49 / $166.89 / $306.76	Professional		$108.49	$166.89	$306.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.36 / $129.08 / $399.00	Facility		$101.36	$129.08	$399.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $143.34 / $170.47 / $180.00	Professional		$143.34	$170.47	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $154.63 / $301.07	Professional		$93.94	$154.63	$301.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $170.47 / $207.05	Professional		$118.33	$170.47	$207.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $172.31 / $254.78	Professional		$118.33	$172.31	$254.78
United Facility/Professional Facility Modifier Low / Median / High Price $772.00 / $2,360.00 / $4,066.00	Facility		$772.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $139.07 / $196.74 / $354.93	Professional		$139.07	$196.74	$354.93