Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $3,548.13 / $8,317.64	Facility		$549.54	$3,548.13	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $371.54 / $3,890.45	Professional		$186.21	$371.54	$3,890.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $398.11	Professional		$177.83	$245.47	$398.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $263.03 / $407.38	Professional		$223.87	$263.03	$407.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $208.93 / $229.09	Professional		$204.17	$208.93	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $269.15 / $478.63	Professional		$165.96	$269.15	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $1,122.02	Professional		$208.93	$251.19	$1,122.02
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $426.58 / $426.58 / $426.58	Professional	22	$426.58	$426.58	$426.58
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	52	$123.03	$123.03	$123.03
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $11.22 / $11.22 / $11.22	Professional	80	$11.22	$11.22	$11.22
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $5.62 / $5.62 / $5.62	Professional	AS	$5.62	$5.62	$5.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $309.03	Professional		$269.15	$309.03	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $1,513.56 / $2,511.89	Facility		$354.81	$1,513.56	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $537.03	Professional		$204.17	$323.59	$537.03