Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.84 / $2,572.00 / $6,915.00	Facility		$138.84	$2,572.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $655.90 / $655.90 / $655.90	Facility	50	$655.90	$655.90	$655.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.45 / $157.28 / $330.05	Professional		$119.45	$157.28	$330.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $192.03 / $410.96 / $591.78	Professional	50	$192.03	$410.96	$591.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $284.07 / $284.07 / $284.07	Professional		$284.07	$284.07	$284.07
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $426.10 / $426.10 / $426.10	Professional	50	$426.10	$426.10	$426.10
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 $118.95 / $178.51 / $352.09	Professional		$118.95	$178.51	$352.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $178.42 / $267.76 / $528.13	Professional	50	$178.42	$267.76	$528.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.42 / $171.17 / $356.60	Facility		$122.42	$171.17	$356.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.67 / $160.77 / $173.14	Professional		$123.67	$160.77	$173.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.03 / $198.85 / $640.00	Facility		$109.03	$198.85	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.80 / $200.58 / $359.63	Professional		$131.80	$200.58	$359.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $196.04 / $390.98	Professional		$140.94	$196.04	$390.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $187.73 / $228.09 / $250.12	Professional		$187.73	$228.09	$250.12
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 $121.45 / $206.34 / $348.43	Professional		$121.45	$206.34	$348.43