Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.25 / $2,221.00 / $5,131.17	Facility		$77.25	$2,221.00	$5,131.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $73.26 / $167.19	Professional		$32.59	$73.26	$167.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $54.79 / $123.06	Professional		$29.51	$54.79	$123.06
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 $37.69 / $76.42 / $150.84	Professional		$37.69	$76.42	$150.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.53 / $114.63 / $226.26	Professional	50	$56.53	$114.63	$226.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.72 / $44.15 / $133.04	Facility		$34.72	$44.15	$133.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $90.49 / $95.03	Professional		$74.98	$90.49	$95.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.54 / $66.63 / $161.29	Professional		$31.54	$66.63	$161.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $90.49 / $115.16	Professional		$40.47	$90.49	$115.16
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,750.00 / $1,750.00 / $1,750.00	Facility		$1,750.00	$1,750.00	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $82.26 / $140.94	Professional		$40.47	$82.26	$140.94
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 $71.06 / $99.30 / $195.17	Professional		$71.06	$99.30	$195.17