Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.26 / $2,987.00 / $6,915.00	Facility		$184.26	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,082.75 / $3,898.00 / $6,250.50	Facility	50	$1,082.75	$3,898.00	$6,250.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $184.26 / $392.47	Professional		$92.46	$184.26	$392.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.69 / $308.17 / $815.94	Professional	50	$138.69	$308.17	$815.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.47 / $169.74 / $361.82	Professional		$110.47	$169.74	$361.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $165.71 / $254.61 / $542.72	Professional	50	$165.71	$254.61	$542.72
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 $88.94 / $137.32 / $263.25	Professional		$88.94	$137.32	$263.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $133.41 / $205.98 / $394.87	Professional	50	$133.41	$205.98	$394.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $94.00 / $131.72 / $269.77	Facility		$94.00	$131.72	$269.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $160.22 / $204.30 / $220.01	Professional		$160.22	$204.30	$220.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.97 / $153.97 / $657.54	Facility		$153.97	$153.97	$657.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.19 / $211.81 / $404.62	Professional		$110.19	$211.81	$404.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.64 / $206.87 / $1,803.00	Professional		$106.64	$206.87	$1,803.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $8.22 / $8.22 / $15.95	Professional	80	$8.22	$8.22	$15.95
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 $135.05 / $253.42 / $318.93	Professional		$135.05	$253.42	$318.93
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 $151.22 / $284.27 / $459.57	Professional		$151.22	$284.27	$459.57