Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $3,911.00 / $6,915.00	Facility		$900.00	$3,911.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,357.00 / $3,146.25 / $3,911.00	Facility	50	$2,357.00	$3,146.25	$3,911.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.06 / $1,259.41 / $2,875.71	Professional		$312.06	$1,259.41	$2,875.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,615.71 / $2,498.85 / $5,787.54	Professional	50	$1,615.71	$2,498.85	$5,787.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $301.25 / $619.91 / $2,173.17	Professional		$301.25	$619.91	$2,173.17
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $464.93 / $3,259.76 / $5,371.77	Professional	50	$464.93	$3,259.76	$5,371.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,406.20 / $4,415.29 / $8,702.00	Facility		$1,406.20	$4,415.29	$8,702.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.06 / $1,474.08 / $3,415.05	Professional		$412.06	$1,474.08	$3,415.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $639.09 / $2,211.13 / $5,176.47	Professional	50	$639.09	$2,211.13	$5,176.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $581.39 / $683.99 / $804.32	Facility		$581.39	$683.99	$804.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $558.72 / $558.72 / $558.72	Facility		$558.72	$558.72	$558.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $404.28 / $1,029.67 / $3,746.02	Professional		$404.28	$1,029.67	$3,746.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.47 / $1,883.41 / $8,976.00	Professional		$389.47	$1,883.41	$8,976.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $372.81 / $1,501.94 / $3,176.36	Professional		$372.81	$1,501.94	$3,176.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,193.00 / $18,613.00	Facility		$1,998.00	$9,193.00	$18,613.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,609.29 / $2,333.87 / $3,927.92	Professional		$1,609.29	$2,333.87	$3,927.92