Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.63 / $1,791.00 / $6,726.00	Facility		$79.63	$1,791.00	$6,726.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $97.10 / $196.81	Professional		$44.50	$97.10	$196.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.69 / $130.44 / $160.97	Professional		$129.69	$130.44	$160.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,139.92 / $3,851.83	Facility		$759.49	$2,139.92	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $116.24 / $221.22	Professional		$56.75	$116.24	$221.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $58.31 / $73.92	Facility		$42.84	$58.31	$73.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $99.18 / $126.94	Professional		$80.48	$99.18	$126.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $546.00	Facility		$75.00	$75.00	$546.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.07 / $125.44 / $218.30	Professional		$59.07	$125.44	$218.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.27 / $104.04 / $284.54	Professional		$49.27	$104.04	$284.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,528.00 / $1,528.00 / $1,528.00	Facility		$1,528.00	$1,528.00	$1,528.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $200.90 / $243.50	Professional		$3.00	$200.90	$243.50
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.51 / $137.25 / $220.94	Professional		$80.51	$137.25	$220.94