Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.75 / $2,960.00 / $6,915.00	Facility		$695.75	$2,960.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $770.96 / $3,535.50 / $7,071.00	Facility	50	$770.96	$3,535.50	$7,071.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.48 / $1,483.16 / $3,338.33	Professional		$308.48	$1,483.16	$3,338.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $538.14 / $2,524.01 / $5,197.85	Professional	50	$538.14	$2,524.01	$5,197.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.81 / $530.37 / $1,851.26	Professional		$266.81	$530.37	$1,851.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $314.30 / $982.92 / $2,257.69	Professional	50	$314.30	$982.92	$2,257.69
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 $383.97 / $1,023.49 / $3,658.74	Professional		$383.97	$1,023.49	$3,658.74
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $575.95 / $1,535.23 / $5,668.47	Professional	50	$575.95	$1,535.23	$5,668.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $335.26 / $399.94 / $614.19	Facility		$335.26	$399.94	$614.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,255.97 / $1,467.25 / $2,715.05	Professional		$1,255.97	$1,467.25	$2,715.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.98 / $500.98 / $500.98	Facility		$500.98	$500.98	$500.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $369.38 / $857.96 / $3,738.29	Professional		$369.38	$857.96	$3,738.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $342.80 / $1,543.20 / $5,067.00	Professional		$342.80	$1,543.20	$5,067.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $1,226.67 / $2,464.78	Professional		$302.39	$1,226.67	$2,464.78
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 $1,401.66 / $2,338.64 / $4,231.83	Professional		$1,401.66	$2,338.64	$4,231.83