Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $3,162.28 / $7,413.10	Facility		$457.09	$3,162.28	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $416.87 / $851.14	Professional		$190.55	$416.87	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $338.84	Professional		$93.33	$169.82	$338.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,862.09 / $4,365.16	Facility		$707.95	$1,862.09	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $691.83	Professional		$257.04	$407.38	$691.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $281.84 / $371.54	Facility		$223.87	$281.84	$371.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $616.60	Professional		$389.05	$489.78	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $724.44 / $2,691.53	Facility		$501.19	$724.44	$2,691.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $446.68 / $831.76	Professional		$239.88	$446.68	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $549.54 / $954.99	Professional		$208.93	$549.54	$954.99
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $549.54 / $691.83 / $1,513.56	Professional	22	$549.54	$691.83	$1,513.56
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $204.17 / $446.68	Professional	52	$158.49	$204.17	$446.68
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $158.49 / $204.17 / $575.44	Professional	53	$158.49	$204.17	$575.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $13,803.84 / $13,803.84	Facility		$5,011.87	$13,803.84	$13,803.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $512.86 / $1,071.52	Professional		$194.98	$512.86	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,454.71 / $5,248.07	Facility		$524.81	$2,454.71	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $416.87 / $794.33	Professional		$208.93	$416.87	$794.33