Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,495.50 / $4,592.00 / $8,367.16	Facility		$1,495.50	$4,592.00	$8,367.16
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,525.00 / $5,231.60 / $17,408.70	Facility	50	$3,525.00	$5,231.60	$17,408.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.72 / $1,223.09 / $3,535.03	Professional		$346.72	$1,223.09	$3,535.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,112.00 / $2,411.03 / $4,490.67	Professional	50	$1,112.00	$2,411.03	$4,490.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.11 / $345.82 / $1,288.70	Professional		$253.11	$345.82	$1,288.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $349.64 / $503.62 / $518.72	Professional	50	$349.64	$503.62	$518.72
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 $459.30 / $1,717.64 / $4,088.95	Professional		$459.30	$1,717.64	$4,088.95
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $708.76 / $2,576.46 / $6,226.33	Professional	50	$708.76	$2,576.46	$6,226.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $421.88 / $506.95 / $778.54	Facility		$421.88	$506.95	$778.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,814.07 / $2,119.23 / $3,933.72	Professional		$1,814.07	$2,119.23	$3,933.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.90 / $621.90 / $621.90	Facility		$621.90	$621.90	$621.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $442.15 / $1,149.44 / $4,401.33	Professional		$442.15	$1,149.44	$4,401.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $434.53 / $2,233.73 / $10,793.00	Professional		$434.53	$2,233.73	$10,793.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $414.11 / $1,781.51 / $3,798.46	Professional		$414.11	$1,781.51	$3,798.46
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 $1,858.26 / $2,620.67 / $4,852.20	Professional		$1,858.26	$2,620.67	$4,852.20