Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.58 / $3,391.00 / $6,915.00	Facility		$123.58	$3,391.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.92 / $107.83 / $223.05	Professional		$74.92	$107.83	$223.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.53 / $205.00 / $205.00	Professional		$124.53	$205.00	$205.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $7,875.00 / $7,875.00	Facility		$7,875.00	$7,875.00	$7,875.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.88 / $126.45 / $212.54	Professional		$80.88	$126.45	$212.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $145.49 / $145.49 / $145.49	Facility		$145.49	$145.49	$145.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.24 / $138.24 / $2,500.00	Facility		$138.24	$138.24	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.06 / $157.05 / $281.79	Professional		$100.06	$157.05	$281.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.26 / $152.41 / $665.00	Professional		$96.26	$152.41	$665.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.80 / $210.65 / $219.41	Professional		$131.80	$210.65	$219.41
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 $102.77 / $165.85 / $273.04	Professional		$102.77	$165.85	$273.04