Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $441.75 / $1,509.00 / $5,946.80	Facility		$441.75	$1,509.00	$5,946.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $908.75 / $908.75 / $2,372.50	Facility	50	$908.75	$908.75	$2,372.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.56 / $205.24 / $382.13	Professional		$126.56	$205.24	$382.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.48 / $244.09 / $258.20	Professional		$177.48	$244.09	$258.20
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 $139.06 / $208.90 / $344.83	Professional		$139.06	$208.90	$344.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $157.76 / $190.63 / $303.83	Facility		$157.76	$190.63	$303.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.83 / $171.76 / $312.44	Professional		$169.83	$171.76	$312.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.01 / $237.11 / $399.85	Professional		$167.01	$237.11	$399.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.29 / $175.88 / $633.00	Professional		$135.29	$175.88	$633.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $9.42 / $9.42 / $9.42	Professional	80	$9.42	$9.42	$9.42
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $4.71 / $4.71 / $4.71	Professional	AS	$4.71	$4.71	$4.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $145.19 / $210.33 / $259.18	Professional		$145.19	$210.33	$259.18
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $145.29 / $210.19 / $323.25	Professional		$145.29	$210.19	$323.25