Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.76 / $1,571.00 / $5,063.00	Facility		$282.76	$1,571.00	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.09 / $287.66 / $545.04	Professional		$164.09	$287.66	$545.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.89 / $375.00 / $503.96	Professional		$251.89	$375.00	$503.96
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 $187.57 / $314.33 / $557.77	Professional		$187.57	$314.33	$557.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $176.04 / $224.29 / $707.04	Facility		$176.04	$224.29	$707.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $271.44 / $324.08 / $341.69	Professional		$271.44	$324.08	$341.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.00 / $321.20 / $636.38	Professional		$195.00	$321.20	$636.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.60 / $324.08 / $392.49	Professional		$205.60	$324.08	$392.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $205.60 / $324.08 / $480.90	Professional		$205.60	$324.08	$480.90
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 $258.64 / $373.58 / $674.77	Professional		$258.64	$373.58	$674.77