Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $247.24 / $2,572.00 / $5,063.00	Facility		$247.24	$2,572.00	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.42 / $200.29 / $526.62	Professional		$69.42	$200.29	$526.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $229.60 / $735.01 / $778.17	Professional	50	$229.60	$735.01	$778.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $116.64 / $454.30	Professional		$58.48	$116.64	$454.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $129.90 / $129.90 / $341.58	Professional	50	$129.90	$129.90	$341.58
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 $71.75 / $116.98 / $221.05	Professional		$71.75	$116.98	$221.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.22 / $178.22 / $349.32	Professional	50	$107.22	$178.22	$349.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.98 / $92.34 / $139.59	Facility		$76.98	$92.34	$139.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $209.10 / $244.28 / $452.23	Professional		$209.10	$244.28	$452.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.83 / $115.83 / $115.83	Facility		$115.83	$115.83	$115.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $182.25 / $527.36	Professional		$83.40	$182.25	$527.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $256.80 / $706.10	Professional		$79.52	$256.80	$706.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $298.83 / $436.60	Professional		$83.56	$298.83	$436.60
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $201.52 / $277.77 / $564.69	Professional		$201.52	$277.77	$564.69