Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $6,726.00 / $12,228.00	Facility		$2,800.00	$6,726.00	$12,228.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $13,554.00 / $13,554.00 / $13,554.00	Facility	50	$13,554.00	$13,554.00	$13,554.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $481.01 / $827.64 / $1,831.49	Professional		$481.01	$827.64	$1,831.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $480.73 / $769.14 / $1,037.51	Professional		$480.73	$769.14	$1,037.51
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 $545.35 / $818.74 / $1,486.58	Professional		$545.35	$818.74	$1,486.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $567.67 / $787.64 / $1,481.27	Facility		$567.67	$787.64	$1,481.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $501.63 / $652.12 / $702.28	Professional		$501.63	$652.12	$702.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $618.99 / $5,845.00 / $10,047.00	Facility		$618.99	$5,845.00	$10,047.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $61.52 / $61.52 / $61.52	Facility	AS	$61.52	$61.52	$61.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $590.50 / $903.30 / $1,408.18	Professional		$590.50	$903.30	$1,408.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $597.52 / $869.12 / $2,215.34	Professional		$597.52	$869.12	$2,215.34
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $43.09 / $43.09 / $43.09	Professional	80	$43.09	$43.09	$43.09
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $21.54 / $21.54 / $21.54	Professional	AS	$21.54	$21.54	$21.54
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 $538.40 / $834.39 / $1,056.22	Professional		$538.40	$834.39	$1,056.22
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 $480.21 / $824.46 / $1,292.96	Professional		$480.21	$824.46	$1,292.96