Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,519.69 / $5,045.00 / $6,915.00	Facility		$1,519.69	$5,045.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,401.77 / $1,689.84 / $3,082.40	Professional		$1,401.77	$1,689.84	$3,082.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,221.11 / $1,221.11 / $1,221.11	Professional		$1,221.11	$1,221.11	$1,221.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $790.00 / $4,803.35 / $17,272.82	Facility		$790.00	$4,803.35	$17,272.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,510.04 / $2,313.23 / $4,041.25	Professional		$1,510.04	$2,313.23	$4,041.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,213.48 / $2,213.48 / $2,213.48	Facility		$2,213.48	$2,213.48	$2,213.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,425.81 / $1,425.81 / $1,425.81	Professional		$1,425.81	$1,425.81	$1,425.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,233.00	Facility		$200.00	$617.00	$1,233.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,467.77 / $2,320.03 / $3,616.85	Professional		$1,467.77	$2,320.03	$3,616.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,510.04 / $1,963.05 / $3,535.18	Professional		$1,510.04	$1,963.05	$3,535.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $2,780.30 / $3,824.20	Professional		$15.00	$2,780.30	$3,824.20
United Facility/Professional Facility Modifier Low / Median / High Price $851.00 / $6,868.00 / $16,000.00	Facility		$851.00	$6,868.00	$16,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,442.47 / $2,099.00 / $3,650.82	Professional		$1,442.47	$2,099.00	$3,650.82