Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.29 / $1,509.00 / $5,063.00	Facility		$107.29	$1,509.00	$5,063.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,695.50 / $2,410.50 / $4,592.00	Facility	50	$1,695.50	$2,410.50	$4,592.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.15 / $87.15 / $217.81	Professional		$44.15	$87.15	$217.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $103.89 / $174.00 / $311.66	Professional	50	$103.89	$174.00	$311.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $39.58 / $137.44	Professional		$38.79	$39.58	$137.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.83 / $37.83 / $230.48	Professional	50	$37.83	$37.83	$230.48
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 $41.83 / $72.06 / $139.47	Professional		$41.83	$72.06	$139.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $62.74 / $108.10 / $209.10	Professional	50	$62.74	$108.10	$209.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.88 / $60.14 / $122.51	Facility		$42.88	$60.14	$122.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.11 / $85.85 / $92.46	Professional		$67.11	$85.85	$92.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.31 / $70.36 / $640.00	Facility		$62.31	$70.36	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $107.48 / $201.95	Professional		$54.65	$107.48	$201.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.44 / $86.83 / $263.19	Professional		$50.44	$86.83	$263.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $74.67 / $133.13	Professional		$52.64	$74.67	$133.13
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 $66.88 / $123.31 / $195.48	Professional		$66.88	$123.31	$195.48