Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $819.05 / $4,852.00 / $8,780.70	Facility		$819.05	$4,852.00	$8,780.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.77 / $286.45 / $1,205.59	Professional		$191.77	$286.45	$1,205.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.80 / $293.68 / $368.09	Professional		$186.80	$293.68	$368.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,000.00 / $7,875.00 / $7,875.00	Facility		$3,000.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.77 / $323.51 / $616.71	Professional		$210.77	$323.51	$616.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $220.95 / $292.80 / $405.08	Facility		$220.95	$292.80	$405.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $194.66 / $253.06 / $272.52	Professional		$194.66	$253.06	$272.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.34 / $3,120.00 / $57,200.00	Facility		$239.34	$3,120.00	$57,200.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $146.80 / $146.80 / $146.80	Facility	62	$146.80	$146.80	$146.80
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $23.49 / $23.49 / $23.49	Facility	AS	$23.49	$23.49	$23.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.01 / $346.04 / $635.45	Professional		$232.01	$346.04	$635.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $240.51 / $353.45 / $1,058.58	Professional		$240.51	$353.45	$1,058.58
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $725.76 / $725.76 / $725.76	Professional	22	$725.76	$725.76	$725.76
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $226.80 / $226.80 / $226.80	Professional	62	$226.80	$226.80	$226.80
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $19.35 / $19.35 / $19.35	Professional	80	$19.35	$19.35	$19.35
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $9.68 / $9.68 / $9.68	Professional	AS	$9.68	$9.68	$9.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $202.54 / $293.68 / $381.50	Professional		$202.54	$293.68	$381.50
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,685.00 / $3,213.00	Facility		$212.00	$1,685.00	$3,213.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.24 / $311.93 / $559.26	Professional		$192.24	$311.93	$559.26