Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.64 / $3,391.00 / $7,245.00	Facility		$263.64	$3,391.00	$7,245.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,141.10 / $4,346.64 / $4,346.64	Facility	50	$2,141.10	$4,346.64	$4,346.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.20 / $236.17 / $561.57	Professional		$121.20	$236.17	$561.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.78 / $35.78 / $1,634.85	Professional	50	$35.78	$35.78	$1,634.85
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 $117.31 / $180.00 / $371.67	Professional		$117.31	$180.00	$371.67
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $175.96 / $270.00 / $557.50	Professional	50	$175.96	$270.00	$557.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $155.12 / $248.19 / $357.68	Facility		$155.12	$248.19	$357.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.89 / $203.89 / $640.00	Facility		$203.89	$203.89	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.46 / $240.03 / $512.30	Professional		$122.46	$240.03	$512.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.12 / $288.50 / $697.96	Professional		$146.12	$288.50	$697.96
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $408.90 / $408.90 / $837.55	Professional	22	$408.90	$408.90	$837.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $184.76 / $354.77 / $446.48	Professional		$184.76	$354.77	$446.48
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 $194.86 / $312.48 / $561.21	Professional		$194.86	$312.48	$561.21