Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $460.43 / $3,109.80 / $6,915.00	Facility		$460.43	$3,109.80	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,665.75 / $3,911.00 / $6,219.60	Facility	50	$1,665.75	$3,911.00	$6,219.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.72 / $418.39 / $928.46	Professional		$208.72	$418.39	$928.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $281.45 / $649.58 / $1,841.84	Professional	50	$281.45	$649.58	$1,841.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.18 / $358.37 / $899.58	Professional		$174.18	$358.37	$899.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $296.39 / $820.54 / $1,349.37	Professional	50	$296.39	$820.54	$1,349.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $990.46 / $2,634.62 / $5,292.58	Facility		$990.46	$2,634.62	$5,292.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.95 / $333.09 / $560.66	Professional		$202.95	$333.09	$560.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $304.42 / $499.63 / $840.99	Professional	50	$304.42	$499.63	$840.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $198.80 / $278.44 / $569.60	Facility		$198.80	$278.44	$569.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $391.98 / $497.03 / $535.26	Professional		$391.98	$497.03	$535.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $326.10 / $326.10 / $1,350.00	Facility		$326.10	$326.10	$1,350.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.56 / $505.79 / $999.20	Professional		$275.56	$505.79	$999.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.16 / $504.95 / $3,349.14	Professional		$225.16	$504.95	$3,349.14
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,363.12 / $2,363.12 / $4,125.00	Facility		$2,363.12	$2,363.12	$4,125.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $287.16 / $625.79 / $778.47	Professional		$287.16	$625.79	$778.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $4,826.00 / $7,889.00	Facility		$1,075.00	$4,826.00	$7,889.00
United Facility/Professional Professional Modifier Low / Median / High Price $362.29 / $653.76 / $1,053.33	Professional		$362.29	$653.76	$1,053.33