Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $3,019.95 / $7,413.10	Facility		$173.78	$3,019.95	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	50	$660.69	$660.69	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $371.54	Professional		$114.82	$158.49	$371.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $177.83 / $416.87 / $758.58	Professional	50	$177.83	$416.87	$758.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $281.84	Professional		$134.90	$199.53	$281.84
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $213.80 / $426.58	Professional	50	$199.53	$213.80	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $2,089.30 / $3,548.13	Facility		$758.58	$2,089.30	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $323.59	Professional		$134.90	$204.17	$323.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $204.17 / $309.03 / $489.78	Professional	50	$204.17	$309.03	$489.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $165.96 / $229.09	Facility		$138.04	$165.96	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $158.49 / $186.21	Professional		$123.03	$158.49	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $199.53 / $645.65	Facility		$109.65	$199.53	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $346.74	Professional		$134.90	$199.53	$346.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $933.25	Professional		$128.82	$190.55	$933.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $1,479.11 / $2,511.89	Facility		$177.83	$1,479.11	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $173.78 / $302.00	Professional		$109.65	$173.78	$302.00