Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $792.50 / $5,063.00 / $7,421.00	Facility		$792.50	$5,063.00	$7,421.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.63 / $473.33 / $991.12	Professional		$370.63	$473.33	$991.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $746.50 / $765.85 / $783.02	Professional		$746.50	$765.85	$783.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,634.62 / $5,292.58	Facility		$964.00	$2,634.62	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $423.06 / $631.47 / $1,150.46	Professional		$423.06	$631.47	$1,150.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $739.05 / $869.46 / $1,208.49	Facility		$739.05	$869.46	$1,208.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $479.11 / $479.11 / $2,225.00	Facility		$479.11	$479.11	$2,225.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $47.57 / $47.57 / $47.57	Facility	AS	$47.57	$47.57	$47.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $442.17 / $670.92 / $1,092.41	Professional		$442.17	$670.92	$1,092.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $463.93 / $674.80 / $2,270.00	Professional		$463.93	$674.80	$2,270.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $16.73 / $16.73 / $16.73	Professional	AS	$16.73	$16.73	$16.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $647.29 / $727.67 / $744.59	Professional		$647.29	$727.67	$744.59
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 $388.98 / $623.48 / $1,073.19	Professional		$388.98	$623.48	$1,073.19