Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $595.83 / $2,595.00 / $6,726.00	Facility		$595.83	$2,595.00	$6,726.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.68 / $575.67 / $1,090.35	Professional		$347.68	$575.67	$1,090.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.37 / $480.39 / $716.81	Professional		$193.37	$480.39	$716.81
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 $387.98 / $556.27 / $1,039.95	Professional		$387.98	$556.27	$1,039.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $672.48 / $813.27 / $1,106.28	Facility		$672.48	$813.27	$1,106.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $661.09 / $661.09 / $2,172.58	Facility		$661.09	$661.09	$2,172.58
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $66.11 / $66.11 / $66.11	Facility	AS	$66.11	$66.11	$66.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $434.35 / $685.02 / $1,226.39	Professional		$434.35	$685.02	$1,226.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $463.31 / $675.66 / $1,375.14	Professional		$463.31	$675.66	$1,375.14
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $30.63 / $30.63 / $44.00	Professional	80	$30.63	$30.63	$44.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $15.31 / $15.31 / $22.00	Professional	AS	$15.31	$15.31	$22.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $514.24 / $702.22 / $990.03	Professional		$514.24	$702.22	$990.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $4,826.00 / $7,889.00	Facility		$1,200.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $491.46 / $721.43 / $1,275.56	Professional		$491.46	$721.43	$1,275.56