Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.75 / $2,960.00 / $6,915.00	Facility		$695.75	$2,960.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $491.63 / $729.76 / $1,428.24	Professional		$491.63	$729.76	$1,428.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $297.89 / $467.47 / $1,387.14	Professional		$297.89	$467.47	$1,387.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,795.56 / $6,315.83	Facility		$964.00	$2,795.56	$6,315.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $484.45 / $730.13 / $1,320.68	Professional		$484.45	$730.13	$1,320.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $844.71 / $1,017.50 / $1,526.16	Facility		$844.71	$1,017.50	$1,526.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.68 / $831.68 / $2,172.58	Facility		$831.68	$831.68	$2,172.58
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $83.17 / $83.17 / $83.17	Facility	AS	$83.17	$83.17	$83.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $607.33 / $943.81 / $1,630.66	Professional		$607.33	$943.81	$1,630.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $579.65 / $845.32 / $1,684.21	Professional		$579.65	$845.32	$1,684.21
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $38.32 / $38.32 / $53.89	Professional	80	$38.32	$38.32	$53.89
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $19.16 / $19.16 / $26.95	Professional	AS	$19.16	$19.16	$26.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $560.23 / $862.05 / $1,256.96	Professional		$560.23	$862.05	$1,256.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,351.00 / $8,836.00	Facility		$1,519.00	$6,351.00	$8,836.00
United Facility/Professional Professional Modifier Low / Median / High Price $653.45 / $1,025.09 / $1,728.90	Professional		$653.45	$1,025.09	$1,728.90