Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.21 / $3,360.00 / $6,915.00	Facility		$124.21	$3,360.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $145.26 / $299.72	Professional		$72.09	$145.26	$299.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $298.64 / $298.64 / $298.64	Professional		$298.64	$298.64	$298.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $1,949.16 / $3,851.83	Facility		$635.46	$1,949.16	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.72 / $113.20 / $224.13	Professional		$75.72	$113.20	$224.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $113.58 / $169.81 / $336.19	Professional	50	$113.58	$169.81	$336.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.06 / $156.87 / $226.08	Facility		$98.06	$156.87	$226.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.72 / $128.72 / $657.54	Facility		$128.72	$128.72	$657.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.31 / $157.32 / $321.16	Professional		$83.31	$157.32	$321.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $167.93 / $404.72	Professional		$92.25	$167.93	$404.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $139.94 / $258.89	Professional		$94.72	$139.94	$258.89
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 $121.00 / $191.41 / $342.28	Professional		$121.00	$191.41	$342.28