Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $4,786.30 / $8,511.38	Facility		$2,290.87	$4,786.30	$8,511.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,888.44 / $8,511.38 / $10,232.93	Facility	50	$5,888.44	$8,511.38	$10,232.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $724.44 / $1,548.82	Professional		$501.19	$724.44	$1,548.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $630.96 / $954.99	Professional		$446.68	$630.96	$954.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,691.53 / $5,754.40	Facility		$891.25	$2,691.53	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $812.83 / $1,318.26	Professional		$524.81	$812.83	$1,318.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $630.96 / $933.25	Facility		$489.78	$630.96	$933.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $588.84 / $776.25	Professional		$489.78	$588.84	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $870.96 / $2,630.27	Facility		$512.86	$870.96	$2,630.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $691.83 / $1,174.90	Professional		$446.68	$691.83	$1,174.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $676.08 / $1,230.27	Professional		$524.81	$676.08	$1,230.27
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,479.11 / $1,479.11 / $1,862.09	Professional	22	$1,479.11	$1,479.11	$1,862.09
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $38.90 / $38.90 / $50.12	Professional	80	$38.90	$38.90	$50.12
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $19.50 / $19.50 / $25.12	Professional	AS	$19.50	$19.50	$25.12
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $5,754.40 / $7,943.28	Facility		$3,715.35	$5,754.40	$7,943.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $977.24 / $1,288.25	Professional		$446.68	$977.24	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $4,677.35 / $8,511.38	Facility		$660.69	$4,677.35	$8,511.38
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $630.96 / $1,148.15	Professional		$467.74	$630.96	$1,148.15