Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.25 / $2,862.50 / $6,858.00	Facility		$656.25	$2,862.50	$6,858.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,312.50 / $2,234.00 / $4,353.00	Facility	50	$1,312.50	$2,234.00	$4,353.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.98 / $465.13 / $961.04	Professional		$247.98	$465.13	$961.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $283.75 / $403.16 / $817.78	Professional		$283.75	$403.16	$817.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $989.09 / $2,795.56 / $6,315.83	Facility		$989.09	$2,795.56	$6,315.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $443.03 / $617.60 / $1,083.47	Professional		$443.03	$617.60	$1,083.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $504.44 / $609.54 / $989.24	Facility		$504.44	$609.54	$989.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $546.70 / $551.35 / $990.91	Professional		$546.70	$551.35	$990.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,942.85 / $6,918.00 / $9,852.00	Facility		$1,942.85	$6,918.00	$9,852.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.48 / $726.35 / $1,098.83	Professional		$467.48	$726.35	$1,098.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $440.47 / $572.61 / $924.64	Professional		$440.47	$572.61	$924.64
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,150.08 / $1,150.08 / $1,150.08	Professional	22	$1,150.08	$1,150.08	$1,150.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $462.49 / $693.61 / $896.93	Professional		$462.49	$693.61	$896.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $4,826.00 / $7,889.00	Facility		$1,200.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $436.94 / $592.26 / $964.45	Professional		$436.94	$592.26	$964.45