Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.65 / $2,595.00 / $6,915.00	Facility		$200.65	$2,595.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.29 / $167.22 / $340.79	Professional		$102.29	$167.22	$340.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.44 / $154.66 / $298.50	Professional		$87.44	$154.66	$298.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $775.91 / $2,476.23 / $5,240.56	Facility		$775.91	$2,476.23	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.91 / $199.43 / $354.58	Professional		$134.91	$199.43	$354.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.53 / $161.87 / $493.96	Facility		$126.53	$161.87	$493.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $161.94 / $192.37 / $202.53	Professional		$161.94	$192.37	$202.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.08 / $172.59 / $337.98	Professional		$113.08	$172.59	$337.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.38 / $192.37 / $267.10	Professional		$148.38	$192.37	$267.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $139.90 / $207.87 / $286.43	Professional		$139.90	$207.87	$286.43
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 $147.32 / $212.16 / $393.56	Professional		$147.32	$212.16	$393.56