Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.35 / $2,410.50 / $6,858.00	Facility		$94.35	$2,410.50	$6,858.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $258.30 / $815.84 / $1,908.50	Facility	50	$258.30	$815.84	$1,908.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.54 / $94.35 / $186.54	Professional		$53.54	$94.35	$186.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $130.29 / $225.00 / $376.35	Professional	50	$130.29	$225.00	$376.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.54 / $62.54 / $185.58	Professional		$62.54	$62.54	$185.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $138.63 / $242.82 / $278.36	Professional	50	$138.63	$242.82	$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 $50.80 / $79.06 / $150.37	Professional		$50.80	$79.06	$150.37
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $76.20 / $118.60 / $225.55	Professional	50	$76.20	$118.60	$225.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.11 / $74.56 / $151.11	Facility		$53.11	$74.56	$151.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.62 / $104.49 / $112.53	Professional		$81.62	$104.49	$112.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.34 / $87.34 / $2,500.00	Facility		$87.34	$87.34	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.63 / $112.04 / $208.54	Professional		$64.63	$112.04	$208.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.74 / $105.61 / $1,002.00	Professional		$59.74	$105.61	$1,002.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,625.05 / $1,625.05 / $6,725.00	Facility		$1,625.05	$1,625.05	$6,725.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.75 / $129.10 / $162.27	Professional		$75.75	$129.10	$162.27
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 $77.51 / $127.43 / $230.80	Professional		$77.51	$127.43	$230.80