Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $523.75 / $2,221.00 / $6,900.00	Facility		$523.75	$2,221.00	$6,900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.10 / $461.90 / $2,371.41	Professional		$89.10	$461.90	$2,371.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.16 / $769.38 / $2,003.89	Professional		$90.16	$769.38	$2,003.89
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 $114.68 / $773.58 / $2,633.39	Professional		$114.68	$773.58	$2,633.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $172.02 / $1,160.36 / $3,874.59	Professional	50	$172.02	$1,160.36	$3,874.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.94 / $182.54 / $74,999.25	Facility		$163.94	$182.54	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.18 / $150.18 / $150.18	Facility		$150.18	$150.18	$150.18
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $93.86 / $93.86 / $93.86	Facility	62	$93.86	$93.86	$93.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.47 / $273.82 / $2,705.45	Professional		$110.47	$273.82	$2,705.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.04 / $859.54 / $5,202.00	Professional		$103.04	$859.54	$5,202.00
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $102.00 / $266.95 / $2,672.19	Professional	62	$102.00	$266.95	$2,672.19
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $8.69 / $22.78 / $228.03	Professional	80	$8.69	$22.78	$228.03
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $4.34 / $11.39 / $114.01	Professional	AS	$4.34	$11.39	$114.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.81 / $333.70 / $1,721.54	Professional		$96.81	$333.70	$1,721.54
United Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $1,550.00 / $2,665.00	Facility		$150.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,119.23 / $1,799.74 / $2,905.23	Professional		$1,119.23	$1,799.74	$2,905.23