Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.68 / $2,760.00 / $6,915.00	Facility		$223.68	$2,760.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,256.58 / $4,126.00 / $4,126.00	Facility	50	$1,256.58	$4,126.00	$4,126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.35 / $259.32 / $554.10	Professional		$123.35	$259.32	$554.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $185.96 / $1,057.32 / $1,122.83	Professional	50	$185.96	$1,057.32	$1,122.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.71 / $476.27 / $541.59	Professional		$113.71	$476.27	$541.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $354.78 / $355.16 / $812.39	Professional	50	$354.78	$355.16	$812.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $1,949.16 / $3,851.83	Facility		$635.46	$1,949.16	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $200.29 / $387.78	Professional		$128.12	$200.29	$387.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $192.18 / $300.43 / $581.66	Professional	50	$192.18	$300.43	$581.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $167.90 / $268.62 / $387.14	Facility		$167.90	$268.62	$387.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $221.83 / $221.83 / $657.54	Facility		$221.83	$221.83	$657.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.30 / $294.32 / $588.72	Professional		$149.30	$294.32	$588.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.94 / $307.83 / $741.85	Professional		$158.94	$307.83	$741.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $159.63 / $256.52 / $473.60	Professional		$159.63	$256.52	$473.60
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 $222.71 / $374.15 / $617.74	Professional		$222.71	$374.15	$617.74