Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.25 / $247.20 / $1,571.00	Facility		$68.25	$247.20	$1,571.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $74.28 / $157.12	Professional		$49.37	$74.28	$157.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $217.40 / $217.40 / $217.40	Professional	50	$217.40	$217.40	$217.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $107.71 / $140.31	Professional		$68.25	$107.71	$140.31
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 $49.51 / $74.23 / $127.24	Professional		$49.51	$74.23	$127.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $74.26 / $108.49 / $192.13	Professional	50	$74.26	$108.49	$192.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.11 / $71.92 / $142.11	Facility		$52.11	$71.92	$142.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $87.31 / $94.02	Professional		$67.55	$87.31	$94.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.75 / $84.93 / $2,500.00	Facility		$62.75	$84.93	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.51 / $89.33 / $144.10	Professional		$56.51	$89.33	$144.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $88.73 / $182.10	Professional		$59.52	$88.73	$182.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $803.63 / $1,750.00 / $5,510.73	Facility		$803.63	$1,750.00	$5,510.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.21 / $92.94 / $135.90	Professional		$59.21	$92.94	$135.90
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 $61.66 / $91.54 / $164.23	Professional		$61.66	$91.54	$164.23