Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,716.56 / $6,017.00 / $10,139.00	Facility		$2,716.56	$6,017.00	$10,139.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $910.11 / $1,232.05 / $3,013.92	Professional		$910.11	$1,232.05	$3,013.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $282.83 / $1,515.20 / $1,970.76	Professional		$282.83	$1,515.20	$1,970.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,614.69 / $5,538.97 / $13,523.26	Facility		$1,614.69	$5,538.97	$13,523.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,067.85 / $1,583.03 / $2,762.80	Professional		$1,067.85	$1,583.03	$2,762.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,115.02 / $1,539.16 / $2,630.55	Facility		$1,115.02	$1,539.16	$2,630.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $986.66 / $1,282.66 / $1,381.32	Professional		$986.66	$1,282.66	$1,381.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,211.14 / $5,845.00 / $10,047.00	Facility		$1,211.14	$5,845.00	$10,047.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $120.27 / $120.27 / $120.27	Facility	AS	$120.27	$120.27	$120.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,123.15 / $1,699.58 / $2,757.37	Professional		$1,123.15	$1,699.58	$2,757.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,167.64 / $1,701.00 / $3,993.18	Professional		$1,167.64	$1,701.00	$3,993.18
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,157.49 / $3,157.49 / $3,157.49	Professional	22	$3,157.49	$3,157.49	$3,157.49
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $84.20 / $84.20 / $84.20	Professional	80	$84.20	$84.20	$84.20
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $42.10 / $42.10 / $42.10	Professional	AS	$42.10	$42.10	$42.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,889.07 / $4,889.07 / $10,313.50	Facility		$4,889.07	$4,889.07	$10,313.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,061.49 / $1,655.93 / $2,113.89	Professional		$1,061.49	$1,655.93	$2,113.89
United Facility/Professional Facility Modifier Low / Median / High Price $2,725.00 / $10,955.00 / $18,613.00	Facility		$2,725.00	$10,955.00	$18,613.00
United Facility/Professional Professional Modifier Low / Median / High Price $951.12 / $1,489.50 / $2,412.57	Professional		$951.12	$1,489.50	$2,412.57