Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,650.75 / $9,488.00 / $19,008.59	Facility		$3,650.75	$9,488.00	$19,008.59
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,440.00 / $12,496.50 / $21,745.50	Facility	50	$4,440.00	$12,496.50	$21,745.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $383.70 / $518.42 / $1,157.92	Professional		$383.70	$518.42	$1,157.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $455.52 / $724.69 / $805.19	Professional		$455.52	$724.69	$805.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $728.00 / $2,976.92 / $9,026.11	Facility		$728.00	$2,976.92	$9,026.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $435.85 / $688.64 / $1,167.80	Professional		$435.85	$688.64	$1,167.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $433.69 / $600.46 / $932.43	Facility		$433.69	$600.46	$932.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $407.23 / $502.73 / $662.36	Professional		$407.23	$502.73	$662.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.00 / $3,237.36 / $9,829.00	Facility		$512.00	$3,237.36	$9,829.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $48.91 / $48.91	Facility	AS	$48.91	$48.91	$48.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.53 / $671.88 / $1,038.78	Professional		$425.53	$671.88	$1,038.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $433.69 / $563.79 / $1,015.32	Professional		$433.69	$563.79	$1,015.32
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,218.38 / $1,218.38 / $1,555.22	Professional	22	$1,218.38	$1,218.38	$1,555.22
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $32.49 / $32.49 / $41.47	Professional	80	$32.49	$32.49	$41.47
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $16.25 / $16.25 / $20.74	Professional	AS	$16.25	$16.25	$20.74
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,889.07 / $6,501.00 / $6,501.00	Facility		$4,889.07	$6,501.00	$6,501.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $453.96 / $693.00 / $1,105.40	Professional		$453.96	$693.00	$1,105.40
United Facility/Professional Facility Modifier Low / Median / High Price $851.00 / $6,868.00 / $16,000.00	Facility		$851.00	$6,868.00	$16,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $405.51 / $561.55 / $951.38	Professional		$405.51	$561.55	$951.38