Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.59 / $2,987.00 / $6,915.00	Facility		$118.59	$2,987.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $118.59 / $266.58	Professional		$57.77	$118.59	$266.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $168.85 / $457.20 / $457.20	Professional	50	$168.85	$457.20	$457.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.51 / $159.51 / $159.51	Professional		$159.51	$159.51	$159.51
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 $55.35 / $108.63 / $194.69	Professional		$55.35	$108.63	$194.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $83.02 / $162.94 / $292.02	Professional	50	$83.02	$162.94	$292.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.90 / $111.84 / $161.18	Facility		$69.90	$111.84	$161.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.61 / $92.61 / $640.00	Facility		$92.61	$92.61	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $160.33 / $282.76	Professional		$86.88	$160.33	$282.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $138.19 / $307.42	Professional		$66.45	$138.19	$307.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.36 / $106.30 / $196.66	Professional		$68.36	$106.30	$196.66
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 $103.46 / $168.46 / $281.76	Professional		$103.46	$168.46	$281.76