Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.63 / $2,171.00 / $6,726.00	Facility		$166.63	$2,171.00	$6,726.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.92 / $167.07 / $312.83	Professional		$77.92	$167.07	$312.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.15 / $68.25 / $96.29	Professional		$48.15	$68.25	$96.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,635.81 / $3,784.98	Facility		$450.00	$1,635.81	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.27 / $194.33 / $386.33	Professional		$103.27	$194.33	$386.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.56 / $103.70 / $124.26	Facility		$77.56	$103.70	$124.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $166.04 / $209.98 / $270.32	Professional		$166.04	$209.98	$270.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $334.00 / $535.00 / $652.00	Facility		$334.00	$535.00	$652.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $180.01 / $390.00	Professional		$96.63	$180.01	$390.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.19 / $199.54 / $307.61	Professional		$89.19	$199.54	$307.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,178.87 / $3,750.00 / $3,750.00	Facility		$2,178.87	$3,750.00	$3,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.40 / $259.55 / $356.10	Professional		$107.40	$259.55	$356.10
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 $157.94 / $226.61 / $392.62	Professional		$157.94	$226.61	$392.62