Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.89 / $2,592.00 / $6,915.00	Facility		$82.89	$2,592.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $520.85 / $853.00 / $2,667.42	Facility	50	$520.85	$853.00	$2,667.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.10 / $85.96 / $176.55	Professional		$57.10	$85.96	$176.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $196.72 / $230.10 / $343.32	Professional	50	$196.72	$230.10	$343.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $118.02 / $164.38	Professional		$77.73	$118.02	$164.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $125.75 / $216.09 / $246.57	Professional	50	$125.75	$216.09	$246.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $105.00 / $180.74	Professional		$65.20	$105.00	$180.74
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $97.80 / $157.50 / $271.11	Professional	50	$97.80	$157.50	$271.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.10 / $83.16 / $169.76	Facility		$59.10	$83.16	$169.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $97.31 / $104.79	Professional		$74.84	$97.31	$104.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.31 / $96.49 / $640.00	Facility		$62.31	$96.49	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $102.96 / $176.50	Professional		$66.30	$102.96	$176.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $99.07 / $201.76	Professional		$67.09	$99.07	$201.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.78 / $106.69 / $146.51	Professional		$73.78	$106.69	$146.51
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $103.32 / $184.77	Professional		$68.94	$103.32	$184.77