Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.57 / $2,572.00 / $6,915.00	Facility		$114.57	$2,572.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.47 / $124.93 / $239.01	Professional		$75.47	$124.93	$239.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.47 / $57.16 / $93.41	Professional	52	$34.47	$57.16	$93.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.42 / $203.88 / $239.85	Professional		$118.42	$203.88	$239.85
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 $82.47 / $134.03 / $244.47	Professional		$82.47	$134.03	$244.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.29 / $99.30 / $304.92	Facility		$77.29	$99.30	$304.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.42 / $142.11 / $150.04	Professional		$118.42	$142.11	$150.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $120.45 / $249.86	Professional		$69.70	$120.45	$249.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.03 / $142.11 / $153.94	Professional		$91.03	$142.11	$153.94
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $48.66 / $48.66 / $75.97	Professional	52	$48.66	$48.66	$75.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.03 / $138.90 / $209.70	Professional		$91.03	$138.90	$209.70
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 $111.00 / $163.16 / $306.52	Professional		$111.00	$163.16	$306.52