Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $429.14 / $2,828.17 / $5,518.20	Facility		$429.14	$2,828.17	$5,518.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.18 / $192.36 / $463.00	Professional		$82.18	$192.36	$463.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.09 / $130.10 / $450.56	Professional		$79.09	$130.10	$450.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.17 / $135.41 / $233.03	Professional		$83.17	$135.41	$233.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.44 / $112.22 / $136.10	Facility		$82.44	$112.22	$136.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $207.64 / $268.54 / $447.64	Professional		$207.64	$268.54	$447.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.17 / $234.84 / $564.99	Professional		$115.17	$234.84	$564.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.81 / $244.26 / $692.27	Professional		$94.81	$244.26	$692.27
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $83.44 / $135.88 / $350.13	Professional	52	$83.44	$135.88	$350.13
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $83.44 / $135.88 / $455.16	Professional	53	$83.44	$135.88	$455.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.86 / $331.79 / $654.40	Professional		$124.86	$331.79	$654.40
United Facility/Professional Facility Modifier Low / Median / High Price $772.00 / $2,360.00 / $4,066.00	Facility		$772.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $253.31 / $381.30 / $563.12	Professional		$253.31	$381.30	$563.12