Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.68 / $3,610.00 / $6,915.00	Facility		$200.68	$3,610.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,742.46 / $4,017.50 / $11,658.10	Facility	50	$1,742.46	$4,017.50	$11,658.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.92 / $200.68 / $403.17	Professional		$106.92	$200.68	$403.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.25 / $316.11 / $856.09	Professional	50	$151.25	$316.11	$856.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.01 / $198.65 / $393.24	Professional		$128.01	$198.65	$393.24
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $162.47 / $286.32 / $589.86	Professional	50	$162.47	$286.32	$589.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,139.92 / $4,143.39	Facility		$741.08	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.46 / $160.66 / $306.24	Professional		$103.46	$160.66	$306.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $155.19 / $240.99 / $459.36	Professional	50	$155.19	$240.99	$459.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.93 / $152.63 / $312.08	Facility		$108.93	$152.63	$312.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.97 / $222.09 / $239.18	Professional		$173.97	$222.09	$239.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.63 / $178.63 / $657.54	Facility		$178.63	$178.63	$657.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $237.18 / $443.58	Professional		$129.75	$237.18	$443.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.37 / $224.56 / $2,086.00	Professional		$123.37	$224.56	$2,086.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,625.05 / $1,625.05 / $3,025.00	Facility		$1,625.05	$1,625.05	$3,025.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $156.59 / $274.38 / $345.31	Professional		$156.59	$274.38	$345.31
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 $169.10 / $312.52 / $494.37	Professional		$169.10	$312.52	$494.37