Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.20 / $2,595.00 / $6,915.00	Facility		$195.20	$2,595.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.29 / $208.18 / $453.28	Professional		$108.29	$208.18	$453.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.18 / $205.89 / $347.39	Professional		$186.18	$205.89	$347.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,825.00 / $4,819.75	Facility		$450.00	$1,825.00	$4,819.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.40 / $240.31 / $447.99	Professional		$135.40	$240.31	$447.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $261.83 / $261.83 / $261.83	Facility		$261.83	$261.83	$261.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.02 / $98.02 / $98.02	Professional		$98.02	$98.02	$98.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $334.00 / $535.00 / $830.39	Facility		$334.00	$535.00	$830.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.01 / $224.92 / $466.13	Professional		$118.01	$224.92	$466.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.03 / $236.77 / $347.95	Professional		$124.03	$236.77	$347.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $409.30 / $599.10	Professional		$5.00	$409.30	$599.10
United Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $2,307.00 / $5,272.00	Facility		$515.00	$2,307.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $190.63 / $266.01 / $448.23	Professional		$190.63	$266.01	$448.23