Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.55 / $3,391.00 / $6,915.00	Facility		$138.55	$3,391.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.76 / $137.60 / $253.54	Professional		$78.76	$137.60	$253.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $523.38 / $523.38 / $686.00	Professional	50	$523.38	$523.38	$686.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Professional		$200.00	$200.00	$200.00
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 $76.93 / $128.66 / $228.44	Professional		$76.93	$128.66	$228.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.39 / $193.00 / $342.66	Professional	50	$115.39	$193.00	$342.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.20 / $160.13 / $228.74	Facility		$99.20	$160.13	$228.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $2,500.00	Facility		$133.72	$133.72	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.07 / $184.85 / $327.04	Professional		$101.07	$184.85	$327.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.41 / $157.65 / $630.00	Professional		$90.41	$157.65	$630.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.56 / $139.38 / $239.09	Professional		$100.56	$139.38	$239.09
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 $115.73 / $212.21 / $336.50	Professional		$115.73	$212.21	$336.50