Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.92 / $2,497.50 / $5,308.55	Facility		$387.92	$2,497.50	$5,308.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $203.82 / $809.17	Professional		$72.56	$203.82	$809.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.14 / $137.41 / $606.55	Professional		$56.14	$137.41	$606.55
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 $99.39 / $273.86 / $792.51	Professional		$99.39	$273.86	$792.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $113.85 / $181.50	Facility		$94.22	$113.85	$181.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $413.24 / $415.33 / $708.49	Professional		$413.24	$415.33	$708.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.73 / $505.17 / $969.09	Professional		$116.73	$505.17	$969.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.90 / $376.96 / $1,396.00	Professional		$88.90	$376.96	$1,396.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.14 / $149.52 / $659.28	Professional		$122.14	$149.52	$659.28
United Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $2,360.00 / $4,066.00	Facility		$424.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $463.27 / $668.70 / $1,034.68	Professional		$463.27	$668.70	$1,034.68