Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $356.88 / $3,038.41 / $6,915.00	Facility		$356.88	$3,038.41	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $87.14 / $177.10 / $483.44	Facility	52	$87.14	$177.10	$483.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.66 / $430.45 / $1,256.09	Professional		$171.66	$430.45	$1,256.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.00 / $303.17 / $1,056.82	Professional		$159.00	$303.17	$1,056.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $568.00 / $2,081.07 / $4,819.75	Facility		$568.00	$2,081.07	$4,819.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.11 / $435.92 / $1,190.91	Professional		$220.11	$435.92	$1,190.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $281.72 / $281.72 / $281.72	Facility		$281.72	$281.72	$281.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $161.29 / $161.29 / $161.29	Professional		$161.29	$161.29	$161.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $448.00 / $715.00 / $1,091.58	Facility		$448.00	$715.00	$1,091.58
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.07 / $404.03 / $1,232.95	Professional		$207.07	$404.03	$1,232.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $196.97 / $558.27 / $943.48	Professional		$196.97	$558.27	$943.48
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $140.35 / $179.14 / $457.45	Professional	52	$140.35	$179.14	$457.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $181.27 / $510.87 / $1,207.66	Professional		$181.27	$510.87	$1,207.66
United Facility/Professional Facility Modifier Low / Median / High Price $535.00 / $1,831.00 / $5,272.00	Facility		$535.00	$1,831.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $237.50 / $648.84 / $1,262.34	Professional		$237.50	$648.84	$1,262.34