Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.58 / $1,976.00 / $5,595.00	Facility		$101.58	$1,976.00	$5,595.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,270.08 / $1,764.00 / $1,811.71	Facility	50	$1,270.08	$1,764.00	$1,811.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.48 / $101.58 / $228.02	Professional		$61.48	$101.58	$228.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $135.80 / $267.97 / $399.04	Professional	50	$135.80	$267.97	$399.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $168.08 / $197.70	Professional		$90.53	$168.08	$197.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $135.80 / $259.37 / $296.56	Professional	50	$135.80	$259.37	$296.56
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 $74.17 / $122.93 / $203.66	Professional		$74.17	$122.93	$203.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $111.25 / $184.39 / $305.49	Professional	50	$111.25	$184.39	$305.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.56 / $83.96 / $165.81	Facility		$61.56	$83.96	$165.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.39 / $115.83 / $124.74	Professional		$89.39	$115.83	$124.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.55 / $100.78 / $2,500.00	Facility		$76.55	$100.78	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $117.06 / $213.64	Professional		$74.00	$117.06	$213.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.55 / $116.27 / $519.00	Professional		$66.55	$116.27	$519.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $172.13 / $172.13 / $288.19	Professional	22	$172.13	$172.13	$288.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.17 / $102.93 / $173.12	Professional		$61.17	$102.93	$173.12
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 $82.21 / $132.34 / $218.21	Professional		$82.21	$132.34	$218.21