Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $65.61 / $149.47	Facility		$26.92	$65.61	$149.47
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $298.95 / $298.95 / $391.32	Facility	50	$298.95	$298.95	$391.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $59.84 / $141.00	Professional		$27.54	$59.84	$141.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.13 / $212.16 / $232.86	Professional	50	$54.13	$212.16	$232.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $56.53 / $126.69	Professional		$53.71	$56.53	$126.69
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $86.50 / $148.38 / $190.04	Professional	50	$86.50	$148.38	$190.04
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 $26.41 / $45.94 / $74.93	Professional		$26.41	$45.94	$74.93
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.61 / $68.91 / $112.39	Professional	50	$39.61	$68.91	$112.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.28 / $37.25 / $75.73	Facility		$27.28	$37.25	$75.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.91 / $72.63 / $78.22	Professional		$56.91	$72.63	$78.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.88 / $44.88 / $2,500.00	Facility		$44.88	$44.88	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $68.14 / $121.61	Professional		$38.13	$68.14	$121.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $73.48 / $151.86	Professional		$30.55	$73.48	$151.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.94 / $56.53 / $109.96	Professional		$30.94	$56.53	$109.96
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 $51.37 / $72.76 / $142.41	Professional		$51.37	$72.76	$142.41