Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,425.00 / $6,389.00 / $12,228.00	Facility		$2,425.00	$6,389.00	$12,228.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $521.83 / $703.79 / $1,900.73	Professional		$521.83	$703.79	$1,900.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $465.89 / $772.05 / $1,046.32	Professional		$465.89	$772.05	$1,046.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,082.02 / $3,851.84 / $13,523.26	Facility		$1,082.02	$3,851.84	$13,523.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $565.97 / $881.47 / $1,534.58	Professional		$565.97	$881.47	$1,534.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $589.26 / $817.18 / $1,591.38	Facility		$589.26	$817.18	$1,591.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $520.74 / $676.96 / $729.04	Professional		$520.74	$676.96	$729.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.04 / $5,845.00 / $10,047.00	Facility		$642.04	$5,845.00	$10,047.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $63.83 / $63.83 / $63.83	Facility	AS	$63.83	$63.83	$63.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $613.28 / $937.48 / $1,461.42	Professional		$613.28	$937.48	$1,461.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $619.92 / $901.71 / $2,120.31	Professional		$619.92	$901.71	$2,120.31
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $22.35 / $22.35 / $22.35	Professional	AS	$22.35	$22.35	$22.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,725.00 / $3,725.00 / $4,233.47	Facility		$3,725.00	$3,725.00	$4,233.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $559.07 / $865.94 / $1,097.10	Professional		$559.07	$865.94	$1,097.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,689.00 / $14,120.00	Facility		$1,519.00	$6,689.00	$14,120.00
United Facility/Professional Professional Modifier Low / Median / High Price $515.37 / $892.20 / $1,434.06	Professional		$515.37	$892.20	$1,434.06