Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.12 / $2,595.00 / $6,915.00	Facility		$70.12	$2,595.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.02 / $90.42 / $249.77	Professional		$40.02	$90.42	$249.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.36 / $172.07 / $211.12	Professional		$73.36	$172.07	$211.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $1,729.39 / $3,784.98	Facility		$480.00	$1,729.39	$3,784.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.08 / $105.45 / $225.64	Professional		$46.08	$105.45	$225.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.70 / $53.77 / $65.19	Facility		$40.70	$53.77	$65.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.68 / $128.19 / $164.00	Professional		$100.68	$128.19	$164.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.44 / $631.54 / $3,200.00	Facility		$69.44	$631.54	$3,200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.89 / $96.81 / $243.70	Professional		$46.89	$96.81	$243.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.81 / $111.01 / $166.52	Professional		$46.81	$111.01	$166.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $127.66 / $201.97	Professional		$56.98	$127.66	$201.97
United Facility/Professional Facility Modifier Low / Median / High Price $77.00 / $866.00 / $2,665.00	Facility		$77.00	$866.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $123.52 / $229.78	Professional		$86.00	$123.52	$229.78