Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $1,513.56 / $5,370.32	Facility		$338.84	$1,513.56	$5,370.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $309.03	Professional		$61.66	$120.23	$309.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $537.03 / $537.03 / $549.54	Professional	50	$537.03	$537.03	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $128.82	Professional		$64.57	$83.18	$128.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,819.70 / $3,548.13	Facility		$741.31	$1,819.70	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $199.53	Professional		$77.62	$120.23	$199.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $117.49 / $181.97 / $302.00	Professional	50	$117.49	$181.97	$302.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $97.72 / $138.04	Facility		$81.28	$97.72	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $177.83	Professional		$120.23	$154.88	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $645.65	Facility		$120.23	$120.23	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $275.42	Professional		$81.28	$141.25	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $186.21 / $489.78	Professional		$77.62	$186.21	$489.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $12,302.69 / $13,489.63	Facility		$4,365.16	$12,302.69	$13,489.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $190.55 / $213.80	Professional		$100.00	$190.55	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,187.76 / $3,467.37	Facility		$426.58	$2,187.76	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $120.23 / $245.47	Professional		$66.07	$120.23	$245.47