Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $651.91 / $2,769.00 / $6,668.29	Facility		$651.91	$2,769.00	$6,668.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.37 / $394.99 / $1,222.44	Professional		$63.37	$394.99	$1,222.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.80 / $102.88 / $1,042.36	Professional		$94.80	$102.88	$1,042.36
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 $83.58 / $492.98 / $1,454.75	Professional		$83.58	$492.98	$1,454.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,160.73 / $1,160.73 / $1,160.73	Facility		$1,160.73	$1,160.73	$1,160.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $60.42 / $60.42	Professional		$60.42	$60.42	$60.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.00 / $546.00 / $770.87	Facility		$338.00	$546.00	$770.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.88 / $200.00 / $1,329.90	Professional		$78.88	$200.00	$1,329.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.88 / $547.76 / $1,380.36	Professional		$72.88	$547.76	$1,380.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $1,321.60 / $1,712.70	Professional		$4.00	$1,321.60	$1,712.70
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 $620.54 / $939.67 / $1,618.33	Professional		$620.54	$939.67	$1,618.33