Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.79 / $2,221.00 / $6,915.00	Facility		$286.79	$2,221.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $57.90 / $238.68 / $1,509.00	Facility	52	$57.90	$238.68	$1,509.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.80 / $342.20 / $824.10	Professional		$115.80	$342.20	$824.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.15 / $874.44 / $874.44	Professional		$161.15	$874.44	$874.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,954.16 / $4,819.75	Facility		$450.00	$1,954.16	$4,819.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.72 / $328.48 / $1,046.83	Professional		$152.72	$328.48	$1,046.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $243.38 / $243.38 / $243.38	Facility		$243.38	$243.38	$243.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.67 / $106.67 / $106.67	Professional		$106.67	$106.67	$106.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.00 / $551.00 / $2,880.00	Facility		$338.00	$551.00	$2,880.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $157.86 / $157.86 / $157.86	Facility	52	$157.86	$157.86	$157.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.80 / $314.02 / $1,053.68	Professional		$154.80	$314.02	$1,053.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $460.12 / $777.60	Professional		$130.82	$460.12	$777.60
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $93.22 / $118.99 / $377.02	Professional	52	$93.22	$118.99	$377.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.17 / $422.33 / $993.23	Professional		$122.17	$422.33	$993.23
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 $180.21 / $553.92 / $1,097.91	Professional		$180.21	$553.92	$1,097.91