Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,388.44 / $7,413.10	Facility		$630.96	$3,388.44	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $741.31 / $3,981.07 / $8,709.64	Facility	50	$741.31	$3,981.07	$8,709.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $186.21 / $467.74	Professional		$87.10	$186.21	$467.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $354.81 / $954.99	Professional	50	$125.89	$354.81	$954.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $371.54	Professional		$93.33	$162.18	$371.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $234.42 / $457.09	Professional	50	$125.89	$234.42	$457.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,089.30 / $3,548.13	Facility		$794.33	$2,089.30	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $245.47	Professional		$107.15	$154.88	$245.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $234.42 / $363.08	Professional	50	$165.96	$234.42	$363.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $125.89 / $173.78	Facility		$104.71	$125.89	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $234.42	Professional		$158.49	$204.17	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $645.65 / $660.69	Facility		$154.88	$645.65	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $389.05	Professional		$107.15	$199.53	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $229.09 / $1,412.54	Professional		$95.50	$229.09	$1,412.54
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $8.13 / $8.13 / $15.85	Professional	80	$8.13	$8.13	$15.85
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,570.88 / $6,760.83	Facility		$3,019.95	$4,570.88	$6,760.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $251.19 / $316.23	Professional		$131.83	$251.19	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,187.76 / $3,467.37	Facility		$426.58	$2,187.76	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $173.78 / $398.11	Professional		$85.11	$173.78	$398.11