Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.47 / $2,760.00 / $6,915.00	Facility		$136.47	$2,760.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.90 / $189.82 / $445.03	Professional		$78.90	$189.82	$445.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $277.73 / $511.50 / $511.50	Professional	50	$277.73	$511.50	$511.50
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 $83.61 / $127.95 / $247.49	Professional		$83.61	$127.95	$247.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.41 / $191.92 / $371.23	Professional	50	$125.41	$191.92	$371.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.17 / $174.66 / $251.73	Facility		$109.17	$174.66	$251.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.26 / $143.26 / $657.54	Facility		$143.26	$143.26	$657.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $209.54 / $474.54	Professional		$92.15	$209.54	$474.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.65 / $258.97 / $632.42	Professional		$102.65	$258.97	$632.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.29 / $218.69 / $404.57	Professional		$104.29	$218.69	$404.57
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 $186.52 / $285.26 / $518.64	Professional		$186.52	$285.26	$518.64