Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $916.76 / $4,592.00 / $9,488.00	Facility		$916.76	$4,592.00	$9,488.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $558.59 / $831.61 / $1,756.61	Professional		$558.59	$831.61	$1,756.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $541.11 / $1,004.62 / $1,549.77	Professional		$541.11	$1,004.62	$1,549.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,402.00 / $5,435.54 / $12,227.65	Facility		$1,402.00	$5,435.54	$12,227.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $574.84 / $853.08 / $1,549.48	Professional		$574.84	$853.08	$1,549.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $997.35 / $1,173.35 / $1,801.94	Facility		$997.35	$1,173.35	$1,801.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $978.60 / $978.60 / $6,814.69	Facility		$978.60	$978.60	$6,814.69
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $97.86 / $97.86 / $97.86	Facility	AS	$97.86	$97.86	$97.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $670.25 / $1,020.33 / $1,792.72	Professional		$670.25	$1,020.33	$1,792.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $683.99 / $985.40 / $1,878.95	Professional		$683.99	$985.40	$1,878.95
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,695.48 / $1,695.48 / $2,254.73	Professional	22	$1,695.48	$1,695.48	$2,254.73
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $45.21 / $45.21 / $60.13	Professional	80	$45.21	$45.21	$60.13
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $22.61 / $22.61 / $30.06	Professional	AS	$22.61	$22.61	$30.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $622.28 / $1,025.16 / $1,649.46	Professional		$622.28	$1,025.16	$1,649.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00
United Facility/Professional Professional Modifier Low / Median / High Price $705.25 / $1,093.78 / $1,741.97	Professional		$705.25	$1,093.78	$1,741.97