Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $2,818.38 / $7,079.46	Facility		$575.44	$2,818.38	$7,079.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $2,398.83 / $6,309.57	Facility	50	$794.33	$2,398.83	$6,309.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $263.03	Professional		$57.54	$104.71	$263.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $194.98 / $436.52	Professional	50	$85.11	$194.98	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $100.00 / $199.53	Professional		$54.95	$100.00	$199.53
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $89.13 / $147.91 / $275.42	Professional	50	$89.13	$147.91	$275.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $7,943.28	Facility		$1,000.00	$1,000.00	$7,943.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $162.18	Professional		$70.79	$102.33	$162.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $154.88 / $239.88	Professional	50	$112.20	$154.88	$239.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $117.49	Facility		$69.18	$83.18	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $131.83	Professional		$87.10	$112.20	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $2,511.89	Facility		$102.33	$102.33	$2,511.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $213.80	Professional		$72.44	$120.23	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $125.89 / $776.25	Professional		$58.88	$125.89	$776.25
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $5,248.07 / $7,585.78	Facility		$3,890.45	$5,248.07	$7,585.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $177.83	Professional		$85.11	$141.25	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,513.56 / $2,511.89	Facility		$177.83	$1,513.56	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $204.17	Professional		$60.26	$102.33	$204.17