Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.16 / $2,760.00 / $7,421.00	Facility		$80.16	$2,760.00	$7,421.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $10.01 / $15.10 / $20.07	Facility	53	$10.01	$15.10	$20.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.26 / $62.22 / $146.36	Professional		$41.26	$62.22	$146.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $47.21 / $78.81	Professional		$38.29	$47.21	$78.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,364.25 / $5,307.44 / $8,204.21	Facility		$4,364.25	$5,307.44	$8,204.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.09 / $73.76 / $135.04	Professional		$47.09	$73.76	$135.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.04 / $58.97 / $86.10	Facility		$42.04	$58.97	$86.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.57 / $54.90 / $96.56	Professional		$53.57	$54.90	$96.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,882.00 / $10,446.00 / $11,874.00	Facility		$5,882.00	$10,446.00	$11,874.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $87.83 / $138.28	Professional		$56.56	$87.83	$138.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.24 / $58.86 / $200.06	Professional		$46.24	$58.86	$200.06
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $6,021.48 / $6,565.42 / $10,327.68	Facility		$6,021.48	$6,565.42	$10,327.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.76 / $60.96 / $83.23	Professional		$57.76	$60.96	$83.23
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,902.00 / $6,000.00	Facility		$353.00	$1,902.00	$6,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.10 / $73.47 / $116.85	Professional		$47.10	$73.47	$116.85