Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.86 / $1,047.50 / $6,726.00	Facility		$97.86	$1,047.50	$6,726.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.94 / $98.10 / $203.32	Professional		$56.94	$98.10	$203.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.04 / $48.77 / $78.39	Professional	52	$28.04	$48.77	$78.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.19 / $144.88 / $191.44	Professional		$102.19	$144.88	$191.44
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 $67.72 / $112.34 / $203.34	Professional		$67.72	$112.34	$203.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $101.40 / $168.51 / $305.01	Professional	50	$101.40	$168.51	$305.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $81.26 / $247.80	Facility		$62.81	$81.26	$247.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.23 / $120.97 / $127.90	Professional		$100.23	$120.97	$127.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.64 / $101.55 / $213.57	Professional		$56.64	$101.55	$213.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $120.97 / $130.30	Professional		$74.48	$120.97	$130.30
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $39.82 / $39.82 / $64.67	Professional	52	$39.82	$39.82	$64.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $117.66 / $178.30	Professional		$74.48	$117.66	$178.30
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 $91.52 / $135.68 / $251.86	Professional		$91.52	$135.68	$251.86