Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,113.96 / $7,041.06 / $14,371.39	Facility		$4,113.96	$7,041.06	$14,371.39
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $5,374.24 / $29,431.04 / $29,431.04	Facility	22	$5,374.24	$29,431.04	$29,431.04
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,542.00 / $9,084.00 / $21,745.50	Facility	50	$4,542.00	$9,084.00	$21,745.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $419.91 / $647.26 / $925.10	Professional		$419.91	$647.26	$925.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $604.11 / $723.61 / $746.72	Professional		$604.11	$723.61	$746.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,464.71 / $5,523.39 / $12,926.58	Facility		$1,464.71	$5,523.39	$12,926.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $404.58 / $631.99 / $1,063.18	Professional		$404.58	$631.99	$1,063.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $467.70 / $565.14 / $903.29	Facility		$467.70	$565.14	$903.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $506.87 / $516.30 / $913.51	Professional		$506.87	$516.30	$913.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,185.25 / $3,185.25 / $3,185.25	Facility		$3,185.25	$3,185.25	$3,185.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $480.43 / $695.00 / $1,159.95	Professional		$480.43	$695.00	$1,159.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $402.20 / $522.86 / $2,510.00	Professional		$402.20	$522.86	$2,510.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $990.34 / $990.34 / $990.34	Professional	22	$990.34	$990.34	$990.34
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,334.00 / $6,765.34 / $10,801.86	Facility		$4,334.00	$6,765.34	$10,801.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $604.24 / $620.55 / $667.65	Professional		$604.24	$620.55	$667.65
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $8,264.00 / $15,490.00	Facility		$1,738.00	$8,264.00	$15,490.00
United Facility/Professional Professional Modifier Low / Median / High Price $432.00 / $618.35 / $1,056.02	Professional		$432.00	$618.35	$1,056.02