Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.93 / $2,422.00 / $4,745.00	Facility		$191.93	$2,422.00	$4,745.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.05 / $170.00 / $532.17	Professional		$55.05	$170.00	$532.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.49 / $88.46 / $432.60	Professional		$54.49	$88.46	$432.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $7,875.00 / $7,875.00	Facility		$7,875.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $166.98 / $497.98	Professional		$71.09	$166.98	$497.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $60.16 / $76.29 / $91.46	Facility		$60.16	$76.29	$91.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $215.80 / $252.10 / $465.63	Professional		$215.80	$252.10	$465.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.11 / $98.11 / $98.11	Facility		$98.11	$98.11	$98.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.91 / $158.79 / $471.20	Professional		$64.91	$158.79	$471.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $248.40 / $569.11	Professional		$68.59	$248.40	$569.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.63 / $365.70 / $503.58	Professional		$92.63	$365.70	$503.58
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $149.69 / $213.18 / $504.24	Professional		$149.69	$213.18	$504.24