Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.69 / $1,643.47 / $5,593.54	Facility		$132.69	$1,643.47	$5,593.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.45 / $132.69 / $282.62	Professional		$60.45	$132.69	$282.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $69.56 / $126.64	Professional		$68.20	$69.56	$126.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $109.56 / $194.47	Professional		$70.59	$109.56	$194.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $105.90 / $164.34 / $291.70	Professional	50	$105.90	$164.34	$291.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.11 / $105.73 / $213.95	Facility		$75.11	$105.73	$213.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $180.02 / $193.87	Professional		$140.82	$180.02	$193.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.26 / $123.26 / $640.00	Facility		$123.26	$123.26	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.39 / $167.00 / $321.61	Professional		$86.39	$167.00	$321.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.67 / $182.23 / $422.22	Professional		$88.67	$182.23	$422.22
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $6,484.00 / $6,484.00 / $8,331.57	Facility		$6,484.00	$6,484.00	$8,331.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.56 / $151.74 / $280.72	Professional		$91.56	$151.74	$280.72
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 $109.74 / $183.97 / $325.61	Professional		$109.74	$183.97	$325.61