Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $841.91 / $3,562.00 / $6,915.00	Facility		$841.91	$3,562.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $469.97 / $815.89 / $1,507.73	Professional		$469.97	$815.89	$1,507.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $466.77 / $466.77 / $466.77	Professional		$466.77	$466.77	$466.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.01 / $5,435.54 / $12,227.65	Facility		$1,206.01	$5,435.54	$12,227.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $506.89 / $743.90 / $1,359.55	Professional		$506.89	$743.90	$1,359.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $880.38 / $1,059.17 / $1,488.45	Facility		$880.38	$1,059.17	$1,488.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $865.11 / $865.11 / $6,097.89	Facility		$865.11	$865.11	$6,097.89
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $86.51 / $86.51 / $86.51	Facility	AS	$86.51	$86.51	$86.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $601.52 / $933.00 / $1,817.10	Professional		$601.52	$933.00	$1,817.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $603.38 / $967.76 / $1,993.06	Professional		$603.38	$967.76	$1,993.06
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $39.89 / $39.89 / $63.78	Professional	80	$39.89	$39.89	$63.78
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $19.94 / $19.94 / $31.89	Professional	AS	$19.94	$19.94	$31.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $586.41 / $919.58 / $1,508.09	Professional		$586.41	$919.58	$1,508.09
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 $696.75 / $992.56 / $1,860.62	Professional		$696.75	$992.56	$1,860.62