Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $792.50 / $3,562.00 / $6,915.00	Facility		$792.50	$3,562.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $767.78 / $1,041.03 / $2,180.59	Professional		$767.78	$1,041.03	$2,180.59
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $312.91 / $545.16 / $626.92	Professional	AS	$312.91	$545.16	$626.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $878.49 / $1,133.57 / $1,903.41	Professional		$878.49	$1,133.57	$1,903.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.01 / $3,514.57 / $6,339.18	Facility		$1,206.01	$3,514.57	$6,339.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $890.21 / $1,233.66 / $2,252.46	Professional		$890.21	$1,233.66	$2,252.46
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $124.62 / $172.71 / $315.33	Professional	AS	$124.62	$172.71	$315.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $813.75 / $1,027.80 / $3,204.29	Facility		$813.75	$1,027.80	$3,204.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $996.55 / $1,169.19 / $1,220.66	Professional		$996.55	$1,169.19	$1,220.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $732.41 / $1,103.08 / $2,084.06	Professional		$732.41	$1,103.08	$2,084.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $942.15 / $1,169.19 / $3,714.00	Professional		$942.15	$1,169.19	$3,714.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $46.05 / $46.05 / $57.14	Professional	80	$46.05	$46.05	$57.14
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $23.02 / $23.02 / $28.57	Professional	AS	$23.02	$23.02	$28.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,087.75 / $1,371.14 / $1,744.32	Professional		$1,087.75	$1,371.14	$1,744.32
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,689.00 / $8,836.00	Facility		$1,519.00	$6,689.00	$8,836.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,001.05 / $1,444.97 / $2,434.36	Professional		$1,001.05	$1,444.97	$2,434.36