Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,352.00 / $5,045.00 / $11,536.00	Facility		$1,352.00	$5,045.00	$11,536.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $515.84 / $681.16 / $1,414.84	Professional		$515.84	$681.16	$1,414.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $262.54 / $729.69 / $1,101.56	Professional		$262.54	$729.69	$1,101.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,082.02 / $3,763.81 / $13,523.26	Facility		$1,082.02	$3,763.81	$13,523.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $596.45 / $909.02 / $1,574.79	Professional		$596.45	$909.02	$1,574.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $620.97 / $860.31 / $1,473.81	Facility		$620.97	$860.31	$1,473.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $549.00 / $713.70 / $768.60	Professional		$549.00	$713.70	$768.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $675.90 / $5,845.00 / $10,047.00	Facility		$675.90	$5,845.00	$10,047.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $67.26 / $67.26 / $67.26	Facility	AS	$67.26	$67.26	$67.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $648.95 / $971.82 / $1,513.37	Professional		$648.95	$971.82	$1,513.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $652.65 / $973.60 / $2,620.00	Professional		$652.65	$973.60	$2,620.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,764.86 / $1,764.86 / $1,764.86	Professional	22	$1,764.86	$1,764.86	$1,764.86
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $47.06 / $47.06 / $47.06	Professional	80	$47.06	$47.06	$47.06
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $23.53 / $23.53 / $23.53	Professional	AS	$23.53	$23.53	$23.53
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $6,105.42 / $6,105.42 / $7,376.00	Facility		$6,105.42	$6,105.42	$7,376.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $593.32 / $931.76 / $1,180.28	Professional		$593.32	$931.76	$1,180.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $10,496.00 / $18,613.00	Facility		$1,998.00	$10,496.00	$18,613.00
United Facility/Professional Professional Modifier Low / Median / High Price $558.01 / $894.91 / $1,476.83	Professional		$558.01	$894.91	$1,476.83