Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.24 / $2,760.00 / $6,915.00	Facility		$139.24	$2,760.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $203.18 / $327.91 / $975.00	Facility	50	$203.18	$327.91	$975.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.83 / $148.90 / $296.94	Professional		$97.83	$148.90	$296.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.61 / $342.00 / $640.82	Professional	50	$164.61	$342.00	$640.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.25 / $255.25 / $288.06	Professional		$255.25	$255.25	$288.06
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $371.13 / $432.09 / $432.09	Professional	50	$371.13	$432.09	$432.09
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 $110.44 / $168.56 / $289.10	Professional		$110.44	$168.56	$289.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $165.66 / $252.84 / $433.65	Professional	50	$165.66	$252.84	$433.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $115.04 / $162.69 / $314.45	Facility		$115.04	$162.69	$314.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.55 / $163.22 / $175.77	Professional		$125.55	$163.22	$175.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.23 / $186.13 / $2,500.00	Facility		$95.23	$186.13	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.17 / $185.58 / $336.87	Professional		$124.17	$185.58	$336.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $185.46 / $1,279.00	Professional		$131.69	$185.46	$1,279.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $178.45 / $235.45 / $254.34	Professional		$178.45	$235.45	$254.34
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 $117.18 / $179.52 / $319.70	Professional		$117.18	$179.52	$319.70