Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $515.65 / $2,625.00 / $5,917.00	Facility		$515.65	$2,625.00	$5,917.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.15 / $440.98 / $1,054.81	Professional		$191.15	$440.98	$1,054.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.45 / $245.92 / $361.39	Professional		$167.45	$245.92	$361.39
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 $248.00 / $461.51 / $981.01	Professional		$248.00	$461.51	$981.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $189.21 / $255.02 / $302.74	Facility		$189.21	$255.02	$302.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $429.79 / $542.78 / $699.60	Professional		$429.79	$542.78	$699.60
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 Professional Modifier Low / Median / High Price $235.78 / $439.84 / $1,050.14	Professional		$235.78	$439.84	$1,050.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $217.59 / $476.81 / $792.29	Professional		$217.59	$476.81	$792.29
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $531.54 / $678.49 / $1,317.05	Professional	22	$531.54	$678.49	$1,317.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,178.87 / $2,958.00 / $2,958.00	Facility		$2,178.87	$2,958.00	$2,958.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $214.19 / $445.60 / $844.35	Professional		$214.19	$445.60	$844.35
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $2,592.00 / $5,272.00	Facility		$550.00	$2,592.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $263.81 / $524.58 / $1,014.69	Professional		$263.81	$524.58	$1,014.69