Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.23 / $2,221.00 / $6,915.00	Facility		$89.23	$2,221.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.09 / $107.35 / $226.90	Professional		$61.09	$107.35	$226.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.35 / $94.35 / $171.74	Professional		$94.35	$94.35	$171.74
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 $74.84 / $125.51 / $219.72	Professional		$74.84	$125.51	$219.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.94 / $74.34 / $305.38	Facility		$59.94	$74.34	$305.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $108.59 / $112.84	Professional		$92.50	$108.59	$112.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.54 / $142.21 / $243.35	Professional		$84.54	$142.21	$243.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.15 / $108.59 / $293.26	Professional		$68.15	$108.59	$293.26
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $1.67 / $1.67 / $2.65	Professional	AS	$1.67	$1.67	$2.65
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 $96.15 / $165.06 / $256.00	Professional		$96.15	$165.06	$256.00