Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $3,295.00 / $6,915.00	Facility		$900.00	$3,295.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.77 / $1,057.93 / $2,531.30	Professional		$302.77	$1,057.93	$2,531.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,761.23 / $1,761.23 / $2,285.19	Professional	50	$1,761.23	$1,761.23	$2,285.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.76 / $599.51 / $1,032.94	Professional		$299.76	$599.51	$1,032.94
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $462.28 / $462.28 / $462.28	Professional	50	$462.28	$462.28	$462.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.01 / $3,514.57 / $6,339.18	Facility		$1,206.01	$3,514.57	$6,339.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $410.24 / $1,397.36 / $3,278.55	Professional		$410.24	$1,397.36	$3,278.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $633.88 / $2,096.04 / $4,917.82	Professional	50	$633.88	$2,096.04	$4,917.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $578.54 / $680.63 / $799.73	Facility		$578.54	$680.63	$799.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $555.64 / $555.64 / $555.64	Facility		$555.64	$555.64	$555.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.25 / $1,024.75 / $3,672.74	Professional		$402.25	$1,024.75	$3,672.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $387.25 / $1,790.43 / $8,477.00	Professional		$387.25	$1,790.43	$8,477.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $368.93 / $1,428.20 / $3,016.25	Professional		$368.93	$1,428.20	$3,016.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,689.00 / $8,836.00	Facility		$1,519.00	$6,689.00	$8,836.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,574.69 / $2,253.79 / $3,888.43	Professional		$1,574.69	$2,253.79	$3,888.43