Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.33 / $1,322.00 / $3,911.00	Facility		$110.33	$1,322.00	$3,911.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $89.15 / $201.36	Professional		$43.43	$89.15	$201.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $144.71 / $157.77	Professional		$36.29	$144.71	$157.77
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 $50.75 / $104.30 / $184.20	Professional		$50.75	$104.30	$184.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.70 / $52.76 / $161.28	Facility		$42.70	$52.76	$161.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.98 / $100.87 / $104.95	Professional		$84.98	$100.87	$104.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $90.88 / $182.47	Professional		$41.48	$90.88	$182.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.37 / $100.87 / $256.64	Professional		$48.37	$100.87	$256.64
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $503.75 / $1,261.90 / $1,750.00	Facility		$503.75	$1,261.90	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.37 / $77.48 / $162.75	Professional		$48.37	$77.48	$162.75
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 $79.02 / $144.10 / $228.71	Professional		$79.02	$144.10	$228.71