Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $5,888.44 / $16,982.44	Facility		$3,162.28	$5,888.44	$16,982.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,819.70 / $3,715.35	Professional		$1,288.25	$1,819.70	$3,715.35
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $181.97 / $346.74 / $933.25	Professional	AS	$181.97	$346.74	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $1,659.59 / $2,630.27	Professional		$239.88	$1,659.59	$2,630.27
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $331.13 / $331.13 / $331.13	Professional	AS	$331.13	$331.13	$331.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $5,623.41 / $12,302.69	Facility		$2,187.76	$5,623.41	$12,302.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,344.23 / $3,235.94	Professional		$1,513.56	$2,344.23	$3,235.94
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $213.80 / $331.13 / $446.68	Professional	AS	$213.80	$331.13	$446.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $2,041.74 / $2,818.38	Facility		$1,698.24	$2,041.74	$2,818.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,737.80 / $1,995.26	Professional		$1,348.96	$1,737.80	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $22,387.21	Facility		$2,454.71	$2,454.71	$22,387.21
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Facility	22	$2,951.21	$2,951.21	$2,951.21
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	AS	$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,344.23 / $3,630.78	Professional		$1,548.82	$2,344.23	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,137.96 / $7,943.28	Professional		$1,479.11	$2,137.96	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Professional	22	$4,265.80	$4,265.80	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	80	$114.82	$114.82	$114.82
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	AS	$56.23	$56.23	$56.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,511.89 / $2,570.40	Professional		$2,238.72	$2,511.89	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $9,332.54 / $28,183.83	Facility		$2,884.03	$9,332.54	$28,183.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,949.84 / $3,235.94	Professional		$1,258.93	$1,949.84	$3,235.94