Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.54 / $1,789.00 / $4,799.00	Facility		$101.54	$1,789.00	$4,799.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.72 / $108.30 / $239.30	Professional		$54.72	$108.30	$239.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.13 / $106.13 / $106.79	Professional		$106.13	$106.13	$106.79
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 $66.27 / $130.21 / $223.76	Professional		$66.27	$130.21	$223.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.91 / $68.31 / $211.16	Facility		$55.91	$68.31	$211.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.75 / $125.76 / $130.46	Professional		$106.75	$125.76	$130.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $133.35 / $265.44	Professional		$66.37	$133.35	$265.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.62 / $125.76 / $256.14	Professional		$62.62	$125.76	$256.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.62 / $100.33 / $202.06	Professional		$62.62	$100.33	$202.06
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 $103.30 / $176.86 / $295.49	Professional		$103.30	$176.86	$295.49