Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.65 / $2,263.50 / $6,900.00	Facility		$101.65	$2,263.50	$6,900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.61 / $101.65 / $196.12	Professional		$62.61	$101.65	$196.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $150.85 / $186.06 / $388.17	Professional	50	$150.85	$186.06	$388.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.51 / $175.99 / $199.30	Professional		$87.51	$175.99	$199.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $298.95 / $298.95 / $298.95	Professional	50	$298.95	$298.95	$298.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $7,875.00 / $7,875.00	Facility		$1,000.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $91.61 / $174.83	Professional		$59.06	$91.61	$174.83
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $88.59 / $137.41 / $262.24	Professional	50	$88.59	$137.41	$262.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.81 / $122.91 / $177.14	Facility		$76.81	$122.91	$177.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.18 / $102.18 / $2,500.00	Facility		$102.18	$102.18	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.67 / $125.69 / $226.63	Professional		$73.67	$125.69	$226.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.02 / $115.35 / $780.97	Professional		$70.02	$115.35	$780.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.95 / $139.34 / $175.36	Professional		$85.95	$139.34	$175.36
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.87 / $141.22 / $249.09	Professional		$80.87	$141.22	$249.09