Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $261.50 / $1,563.00 / $4,592.00	Facility		$261.50	$1,563.00	$4,592.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $623.74 / $1,864.71 / $3,331.50	Facility	50	$623.74	$1,864.71	$3,331.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $23.38 / $32.88 / $58.41	Facility	52	$23.38	$32.88	$58.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.75 / $68.41 / $162.66	Professional		$46.75	$68.41	$162.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.70 / $92.67 / $257.55	Professional	50	$78.70	$92.67	$257.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.71 / $82.60 / $118.53	Professional		$55.71	$82.60	$118.53
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $89.98 / $130.47 / $194.83	Professional	50	$89.98	$130.47	$194.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $2,067.41 / $3,851.83	Facility		$635.46	$2,067.41	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $85.94 / $144.75	Professional		$53.69	$85.94	$144.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $80.53 / $128.91 / $217.12	Professional	50	$80.53	$128.91	$217.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.15 / $66.42 / $135.06	Facility		$47.15	$66.42	$135.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $76.56 / $82.46	Professional		$58.90	$76.56	$82.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.28 / $77.04 / $640.00	Facility		$46.28	$77.04	$640.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $86.30 / $145.57	Professional		$54.54	$86.30	$145.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.39 / $78.47 / $158.24	Professional		$53.39	$78.47	$158.24
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $132.34 / $132.34 / $189.89	Professional	22	$132.34	$132.34	$189.89
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $38.60 / $38.60 / $55.38	Professional	52	$38.60	$38.60	$55.38
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $566.44 / $1,276.90 / $1,750.00	Facility		$566.44	$1,276.90	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $75.56 / $113.93	Professional		$47.54	$75.56	$113.93
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 $54.30 / $91.23 / $154.84	Professional		$54.30	$91.23	$154.84