Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.35 / $2,221.00 / $6,759.80	Facility		$94.35	$2,221.00	$6,759.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $874.82 / $2,059.56 / $6,618.18	Facility	50	$874.82	$2,059.56	$6,618.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $94.35 / $199.47	Professional		$52.85	$94.35	$199.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $71.97 / $153.11 / $544.42	Professional	50	$71.97	$153.11	$544.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.38 / $94.60 / $185.58	Professional		$62.38	$94.60	$185.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $93.56 / $137.96 / $278.36	Professional	50	$93.56	$137.96	$278.36
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 $49.82 / $78.63 / $147.47	Professional		$49.82	$78.63	$147.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $74.73 / $117.94 / $221.20	Professional	50	$74.73	$117.94	$221.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.87 / $74.37 / $142.43	Facility		$52.87	$74.37	$142.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $82.23 / $105.64 / $113.76	Professional		$82.23	$105.64	$113.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.87 / $86.87 / $2,500.00	Facility		$86.87	$86.87	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $112.04 / $207.69	Professional		$63.42	$112.04	$207.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.45 / $106.94 / $829.00	Professional		$59.45	$106.94	$829.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $4.58 / $4.58 / $8.17	Professional	80	$4.58	$4.58	$8.17
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,625.05 / $1,625.05 / $4,975.00	Facility		$1,625.05	$1,625.05	$4,975.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $129.71 / $163.24	Professional		$73.73	$129.71	$163.24
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 $77.61 / $130.40 / $231.94	Professional		$77.61	$130.40	$231.94