Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.73 / $3,391.00 / $9,488.00	Facility		$262.73	$3,391.00	$9,488.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.76 / $158.58 / $358.90	Professional		$129.76	$158.58	$358.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.27 / $254.60 / $287.05	Professional		$154.27	$254.60	$287.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $7,875.00 / $7,875.00	Facility		$7,875.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.81 / $213.60 / $369.48	Professional		$142.81	$213.60	$369.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $150.47 / $198.84 / $274.26	Facility		$150.47	$198.84	$274.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $133.37 / $173.38 / $186.72	Professional		$133.37	$173.38	$186.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.66 / $163.66 / $2,500.00	Facility		$163.66	$163.66	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	AS	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.16 / $236.28 / $373.80	Professional		$155.16	$236.28	$373.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.24 / $232.70 / $403.59	Professional		$156.24	$232.70	$403.59
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $11.27 / $11.27 / $11.27	Professional	80	$11.27	$11.27	$11.27
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $5.63 / $5.63 / $5.63	Professional	AS	$5.63	$5.63	$5.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $211.40 / $251.35 / $262.77	Professional		$211.40	$251.35	$262.77
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 $130.07 / $209.12 / $322.64	Professional		$130.07	$209.12	$322.64