Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.94 / $2,987.00 / $6,915.00	Facility		$134.94	$2,987.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $623.75 / $623.75 / $623.75	Facility	50	$623.75	$623.75	$623.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $134.13 / $258.08	Professional		$91.00	$134.13	$258.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $573.92 / $573.92 / $606.12	Professional	50	$573.92	$573.92	$606.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.14 / $2,139.92 / $4,143.39	Facility		$734.14	$2,139.92	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.33 / $142.32 / $276.47	Professional		$100.33	$142.32	$276.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $150.50 / $213.48 / $413.10	Professional	50	$150.50	$213.48	$413.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.65 / $221.84 / $319.70	Facility		$138.65	$221.84	$319.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.48 / $178.35 / $640.00	Facility		$117.48	$178.35	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.46 / $159.97 / $318.35	Professional		$100.46	$159.97	$318.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $172.03 / $414.61	Professional		$129.84	$172.03	$414.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $133.59 / $183.17 / $261.33	Professional		$133.59	$183.17	$261.33
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 $104.21 / $160.53 / $333.37	Professional		$104.21	$160.53	$333.37