Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.00 / $2,800.00 / $6,915.00	Facility		$203.00	$2,800.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.16 / $203.00 / $346.09	Professional		$124.16	$203.00	$346.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $374.61 / $374.61 / $374.61	Professional		$374.61	$374.61	$374.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $1,729.39 / $3,784.98	Facility		$480.00	$1,729.39	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.08 / $263.13 / $430.19	Professional		$153.08	$263.13	$430.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $247.35 / $247.35 / $247.35	Facility		$247.35	$247.35	$247.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.76 / $115.76 / $115.76	Professional		$115.76	$115.76	$115.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.00 / $471.00 / $551.00	Facility		$338.00	$471.00	$551.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.49 / $233.81 / $443.55	Professional		$142.49	$233.81	$443.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.29 / $230.08 / $350.12	Professional		$143.29	$230.08	$350.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $329.10 / $540.50	Professional		$5.00	$329.10	$540.50
United Facility/Professional Facility Modifier Low / Median / High Price $77.00 / $866.00 / $2,665.00	Facility		$77.00	$866.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.50 / $252.08 / $431.22	Professional		$176.50	$252.08	$431.22