Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $730.63 / $4,590.00 / $6,915.00	Facility		$730.63	$4,590.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $468.25 / $729.95 / $1,538.41	Professional		$468.25	$729.95	$1,538.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $482.44 / $712.16 / $1,365.23	Professional		$482.44	$712.16	$1,365.23
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 $460.50 / $695.41 / $1,253.33	Professional		$460.50	$695.41	$1,253.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $803.15 / $967.83 / $1,451.06	Facility		$803.15	$967.83	$1,451.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $789.27 / $789.27 / $2,172.58	Facility		$789.27	$789.27	$2,172.58
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $78.93 / $78.93 / $78.93	Facility	AS	$78.93	$78.93	$78.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $553.37 / $896.02 / $1,597.34	Professional		$553.37	$896.02	$1,597.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $551.35 / $807.08 / $1,656.95	Professional		$551.35	$807.08	$1,656.95
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $36.45 / $36.45 / $53.02	Professional	80	$36.45	$36.45	$53.02
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $18.22 / $18.22 / $26.51	Professional	AS	$18.22	$18.22	$26.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $532.85 / $829.13 / $1,240.95	Professional		$532.85	$829.13	$1,240.95
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 $630.73 / $944.49 / $1,550.84	Professional		$630.73	$944.49	$1,550.84