Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.57 / $135.19 / $578.25	Facility		$63.57	$135.19	$578.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.13 / $90.98 / $199.97	Professional		$62.13	$90.98	$199.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $170.83 / $170.83 / $685.16	Professional	50	$170.83	$170.83	$685.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.12 / $128.19 / $170.83	Professional		$95.12	$128.19	$170.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $90.26 / $161.51	Professional		$62.42	$90.26	$161.51
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.63 / $135.38 / $242.26	Professional	50	$93.63	$135.38	$242.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.69 / $91.34 / $180.51	Facility		$65.69	$91.34	$180.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.70 / $105.64 / $113.76	Professional		$81.70	$105.64	$113.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.98 / $106.72 / $2,500.00	Facility		$80.98	$106.72	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.33 / $112.54 / $195.00	Professional		$68.33	$112.54	$195.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $110.23 / $221.71	Professional		$75.59	$110.23	$221.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $110.24 / $160.99	Professional		$66.78	$110.24	$160.99
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.43 / $115.00 / $201.43	Professional		$74.43	$115.00	$201.43