Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $890.50 / $5,024.20 / $9,488.00	Facility		$890.50	$5,024.20	$9,488.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,206.00 / $5,607.00 / $17,670.00	Facility	50	$4,206.00	$5,607.00	$17,670.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $567.40 / $700.23 / $1,674.81	Professional		$567.40	$700.23	$1,674.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $692.46 / $1,113.18 / $1,219.66	Professional		$692.46	$1,113.18	$1,219.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,135.89 / $2,987.00 / $6,315.83	Facility		$1,135.89	$2,987.00	$6,315.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.96 / $881.27 / $1,543.88	Professional		$549.96	$881.27	$1,543.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $755.41 / $912.79 / $1,475.37	Facility		$755.41	$912.79	$1,475.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $817.34 / $824.67 / $1,487.09	Professional		$817.34	$824.67	$1,487.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,942.85 / $1,942.85 / $1,942.85	Facility		$1,942.85	$1,942.85	$1,942.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.32 / $1,103.27 / $1,634.38	Professional		$602.32	$1,103.27	$1,634.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $656.93 / $854.01 / $1,110.21	Professional		$656.93	$854.01	$1,110.21
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,530.71 / $1,530.71 / $1,530.71	Professional	22	$1,530.71	$1,530.71	$1,530.71
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $40.82 / $40.82 / $40.82	Professional	80	$40.82	$40.82	$40.82
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $20.41 / $20.41 / $20.41	Professional	AS	$20.41	$20.41	$20.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $689.78 / $1,004.85 / $1,321.17	Professional		$689.78	$1,004.85	$1,321.17
United Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $4,826.00 / $7,889.00	Facility		$1,200.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $570.46 / $824.46 / $1,504.57	Professional		$570.46	$824.46	$1,504.57