Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $279.47 / $3,184.92 / $5,063.00	Facility		$279.47	$3,184.92	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.09 / $239.61 / $571.21	Professional		$103.09	$239.61	$571.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.61 / $199.54 / $535.26	Professional		$130.61	$199.54	$535.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,139.92 / $4,143.39	Facility		$741.08	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.47 / $161.66 / $312.20	Professional		$105.47	$161.66	$312.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.01 / $145.68 / $216.01	Facility		$111.01	$145.68	$216.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $233.81 / $296.52 / $319.33	Professional		$233.81	$296.52	$319.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.22 / $182.22 / $1,150.00	Facility		$182.22	$182.22	$1,150.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.72 / $265.58 / $591.32	Professional		$136.72	$265.58	$591.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.36 / $301.45 / $1,757.00	Professional		$125.36	$301.45	$1,757.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,625.05 / $1,625.05 / $2,150.00	Facility		$1,625.05	$1,625.05	$2,150.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.19 / $241.95 / $489.40	Professional		$109.19	$241.95	$489.40
United Facility/Professional Facility Modifier Low / Median / High Price $426.00 / $2,360.00 / $4,066.00	Facility		$426.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $199.49 / $353.58 / $587.07	Professional		$199.49	$353.58	$587.07