Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.44 / $2,987.00 / $6,915.00	Facility		$142.44	$2,987.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.89 / $157.63 / $297.55	Professional		$93.89	$157.63	$297.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.06 / $235.53 / $300.88	Professional		$162.06	$235.53	$300.88
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 $111.22 / $177.83 / $299.82	Professional		$111.22	$177.83	$299.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.55 / $116.29 / $288.88	Facility		$91.55	$116.29	$288.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $149.25 / $178.27 / $187.89	Professional		$149.25	$178.27	$187.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.86 / $157.91 / $314.05	Professional		$92.86	$157.91	$314.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.60 / $178.27 / $384.56	Professional		$106.60	$178.27	$384.56
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $195.38 / $195.38 / $326.72	Professional	22	$195.38	$195.38	$326.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.60 / $166.02 / $264.91	Professional		$106.60	$166.02	$264.91
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 $138.43 / $214.33 / $384.50	Professional		$138.43	$214.33	$384.50