Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $792.50 / $4,450.60 / $9,067.27	Facility		$792.50	$4,450.60	$9,067.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.25 / $613.07 / $1,331.66	Professional		$384.25	$613.07	$1,331.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $277.35 / $566.58 / $790.70	Professional		$277.35	$566.58	$790.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,082.02 / $2,986.70 / $6,315.83	Facility		$1,082.02	$2,986.70	$6,315.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $417.74 / $588.08 / $1,079.55	Professional		$417.74	$588.08	$1,079.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $438.25 / $574.50 / $851.85	Facility		$438.25	$574.50	$851.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $537.90 / $696.93 / $750.54	Professional		$537.90	$696.93	$750.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $713.96 / $713.96 / $1,653.56	Facility		$713.96	$713.96	$1,653.56
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $71.40 / $71.40 / $71.40	Facility	AS	$71.40	$71.40	$71.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.21 / $735.89 / $1,350.67	Professional		$455.21	$735.89	$1,350.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.29 / $704.30 / $1,452.80	Professional		$501.29	$704.30	$1,452.80
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,242.60 / $1,242.60 / $1,743.36	Professional	22	$1,242.60	$1,242.60	$1,743.36
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $33.14 / $33.14 / $46.49	Professional	80	$33.14	$33.14	$46.49
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $16.57 / $16.57 / $23.24	Professional	AS	$16.57	$16.57	$23.24
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,363.12 / $2,363.12 / $4,125.00	Facility		$2,363.12	$2,363.12	$4,125.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $512.04 / $758.18 / $1,134.64	Professional		$512.04	$758.18	$1,134.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $4,826.00 / $7,889.00	Facility		$1,075.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $538.82 / $825.41 / $1,491.34	Professional		$538.82	$825.41	$1,491.34