Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.91 / $3,158.60 / $4,949.39	Facility		$156.91	$3,158.60	$4,949.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.58 / $105.22 / $222.00	Professional		$56.58	$105.22	$222.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $96.54 / $190.43	Professional		$70.20	$96.54	$190.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,098.00 / $3,851.83	Facility		$759.49	$2,098.00	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.91 / $124.95 / $216.12	Professional		$66.91	$124.95	$216.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.31 / $69.36 / $212.17	Facility		$56.31	$69.36	$212.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $122.83 / $127.58	Professional		$104.00	$122.83	$127.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $114.21 / $215.50	Professional		$54.56	$114.21	$215.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.58 / $122.83 / $259.54	Professional		$63.58	$122.83	$259.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $283.35 / $688.80 / $1,750.00	Facility		$283.35	$688.80	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.58 / $101.87 / $197.36	Professional		$63.58	$101.87	$197.36
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 $99.21 / $162.85 / $266.89	Professional		$99.21	$162.85	$266.89