Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $565.66 / $3,778.00 / $6,915.00	Facility		$565.66	$3,778.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.94 / $565.66 / $1,188.02	Professional		$403.94	$565.66	$1,188.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $494.28 / $746.98 / $791.97	Professional		$494.28	$746.98	$791.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $578.00 / $2,174.58 / $4,819.75	Facility		$578.00	$2,174.58	$4,819.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $458.46 / $734.65 / $1,262.09	Professional		$458.46	$734.65	$1,262.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $674.29 / $674.29 / $674.29	Facility		$674.29	$674.29	$674.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $393.29 / $393.29 / $393.29	Professional		$393.29	$393.29	$393.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.00 / $703.00 / $969.29	Facility		$512.00	$703.00	$969.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.73 / $694.01 / $1,196.06	Professional		$423.73	$694.01	$1,196.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $490.56 / $631.86 / $998.65	Professional		$490.56	$631.86	$998.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $489.91 / $699.58 / $1,000.60	Professional		$489.91	$699.58	$1,000.60
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 $482.54 / $686.65 / $1,189.21	Professional		$482.54	$686.65	$1,189.21