Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.99 / $2,221.00 / $6,915.00	Facility		$310.99	$2,221.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $523.75 / $1,607.00 / $2,504.50	Facility	50	$523.75	$1,607.00	$2,504.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.77 / $870.92 / $1,923.97	Professional		$189.77	$870.92	$1,923.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,486.13 / $1,486.13 / $3,349.98	Professional	50	$1,486.13	$1,486.13	$3,349.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $1,049.63 / $1,224.56	Professional		$152.97	$1,049.63	$1,224.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $142.13 / $142.13 / $142.13	Professional	50	$142.13	$142.13	$142.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $7,875.00 / $7,875.00	Facility		$7,875.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.83 / $553.51 / $1,828.10	Professional		$223.83	$553.51	$1,828.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $335.75 / $830.26 / $2,742.16	Professional	50	$335.75	$830.26	$2,742.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $303.74 / $357.33 / $511.97	Facility		$303.74	$357.33	$511.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.37 / $562.72 / $2,040.40	Professional		$220.37	$562.72	$2,040.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $202.38 / $849.95 / $1,305.83	Professional		$202.38	$849.95	$1,305.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $197.75 / $772.04 / $1,491.27	Professional		$197.75	$772.04	$1,491.27
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $868.81 / $1,239.04 / $2,284.96	Professional		$868.81	$1,239.04	$2,284.96