Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,630.78 / $7,413.10	Facility		$630.96	$3,630.78	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $123.03	Professional		$33.88	$57.54	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $154.88 / $213.80	Professional	50	$69.18	$154.88	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $91.20	Professional		$41.69	$48.98	$91.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $77.62 / $154.88	Professional	50	$77.62	$77.62	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $2,089.30 / $3,548.13	Facility		$758.58	$2,089.30	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $107.15	Professional		$43.65	$60.26	$107.15
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $64.57 / $89.13 / $158.49	Professional	50	$64.57	$89.13	$158.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $46.77 / $64.57	Facility		$38.90	$46.77	$64.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $58.88 / $67.61	Professional		$45.71	$58.88	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $57.54 / $2,511.89	Facility		$30.90	$57.54	$2,511.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $112.20	Professional		$41.69	$64.57	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $63.10 / $263.03	Professional		$35.48	$63.10	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $70.79 / $79.43	Professional		$47.86	$70.79	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,479.11 / $2,511.89	Facility		$177.83	$1,479.11	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $97.72	Professional		$36.31	$56.23	$97.72