Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.63 / $3,634.00 / $7,421.00	Facility		$92.63	$3,634.00	$7,421.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,974.00 / $1,974.00 / $1,974.00	Facility	50	$1,974.00	$1,974.00	$1,974.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.66 / $99.35 / $217.90	Professional		$55.66	$99.35	$217.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $339.27 / $339.27 / $339.27	Professional	50	$339.27	$339.27	$339.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.36 / $105.48 / $112.06	Professional		$60.36	$105.48	$112.06
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 $61.65 / $95.91 / $174.92	Professional		$61.65	$95.91	$174.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $92.47 / $143.50 / $262.38	Professional	50	$92.47	$143.50	$262.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.40 / $93.56 / $177.51	Facility		$66.40	$93.56	$177.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $135.46 / $145.88	Professional		$105.33	$135.46	$145.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.45 / $109.26 / $640.00	Facility		$89.45	$109.26	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $132.88 / $275.58	Professional		$76.09	$132.88	$275.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.47 / $137.12 / $326.52	Professional		$78.47	$137.12	$326.52
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $7,271.50 / $11,156.35 / $25,847.32	Facility		$7,271.50	$11,156.35	$25,847.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.21 / $114.61 / $208.88	Professional		$84.21	$114.61	$208.88
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 $74.16 / $121.61 / $262.56	Professional		$74.16	$121.61	$262.56