Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.37 / $2,950.00 / $6,915.00	Facility		$133.37	$2,950.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.79 / $141.38 / $278.88	Professional		$72.79	$141.38	$278.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $996.37 / $2,722.51 / $5,292.58	Facility		$996.37	$2,722.51	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.54 / $155.99 / $267.33	Professional		$93.54	$155.99	$267.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.30 / $114.99 / $307.30	Facility		$82.30	$114.99	$307.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $138.41 / $163.97 / $172.14	Professional		$138.41	$163.97	$172.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.02 / $144.16 / $292.33	Professional		$79.02	$144.16	$292.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $163.97 / $475.00	Professional		$90.53	$163.97	$475.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $119.92 / $191.82 / $265.05	Professional		$119.92	$191.82	$265.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,036.00 / $3,250.00 / $5,272.00	Facility		$1,036.00	$3,250.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.60 / $209.50 / $374.52	Professional		$131.60	$209.50	$374.52