Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,295.00 / $4,316.20 / $9,754.00	Facility		$1,295.00	$4,316.20	$9,754.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $321.62 / $1,511.68	Professional		$169.00	$321.62	$1,511.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.83 / $244.61 / $313.54	Professional		$47.83	$244.61	$313.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $875.94 / $6,345.18 / $14,509.03	Facility		$875.94	$6,345.18	$14,509.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.28 / $298.36 / $1,223.20	Professional		$169.28	$298.36	$1,223.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $178.99 / $244.88 / $516.32	Facility		$178.99	$244.88	$516.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $206.34 / $222.21	Professional		$158.72	$206.34	$222.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.23 / $6,918.00 / $10,047.00	Facility		$194.23	$6,918.00	$10,047.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $19.01 / $19.01 / $19.01	Facility	AS	$19.01	$19.01	$19.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.05 / $336.82 / $1,231.95	Professional		$188.05	$336.82	$1,231.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $185.77 / $285.41 / $2,771.51	Professional		$185.77	$285.41	$2,771.51
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $13.40 / $13.40 / $13.40	Professional	80	$13.40	$13.40	$13.40
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $6.70 / $6.70 / $6.70	Professional	AS	$6.70	$6.70	$6.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,209.00 / $5,209.00 / $9,265.06	Facility		$5,209.00	$5,209.00	$9,265.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $164.84 / $252.83 / $312.43	Professional		$164.84	$252.83	$312.43
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 $158.56 / $323.29 / $965.98	Professional		$158.56	$323.29	$965.98