Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.56 / $1,509.00 / $5,063.00	Facility		$117.56	$1,509.00	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $117.56 / $279.43	Professional		$64.45	$117.56	$279.43
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $537.44 / $537.44 / $553.89	Professional	50	$537.44	$537.44	$553.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $69.41 / $122.72	Professional		$66.09	$69.41	$122.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $2,067.41 / $3,851.83	Facility		$635.46	$2,067.41	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.95 / $103.22 / $201.15	Professional		$67.95	$103.22	$201.15
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $101.94 / $154.83 / $301.72	Professional	50	$101.94	$154.83	$301.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.73 / $102.46 / $205.74	Facility		$72.73	$102.46	$205.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.94 / $155.10 / $167.03	Professional		$120.94	$155.10	$167.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.82 / $119.82 / $657.54	Facility		$119.82	$119.82	$657.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.25 / $149.10 / $278.02	Professional		$83.25	$149.10	$278.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.93 / $156.86 / $374.14	Professional		$85.93	$156.86	$374.14
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,325.00 / $4,325.00 / $5,708.77	Facility		$4,325.00	$4,325.00	$5,708.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.06 / $129.37 / $239.34	Professional		$92.06	$129.37	$239.34
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 $100.16 / $174.83 / $293.77	Professional		$100.16	$174.83	$293.77