Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $875.50 / $3,295.00 / $7,343.70	Facility		$875.50	$3,295.00	$7,343.70
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,660.00 / $2,660.00 / $3,367.01	Facility	50	$2,660.00	$2,660.00	$3,367.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $539.73 / $707.46 / $1,443.93	Professional		$539.73	$707.46	$1,443.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $570.16 / $798.22 / $1,126.45	Professional		$570.16	$798.22	$1,126.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $869.00 / $2,292.94 / $5,240.56	Facility		$869.00	$2,292.94	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $551.04 / $851.29 / $1,648.40	Professional		$551.04	$851.29	$1,648.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $632.24 / $855.24 / $1,503.57	Facility		$632.24	$855.24	$1,503.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $558.23 / $725.70 / $781.52	Professional		$558.23	$725.70	$781.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.89 / $691.89 / $1,272.50	Facility		$691.89	$691.89	$1,272.50
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $68.64 / $68.64 / $68.64	Facility	AS	$68.64	$68.64	$68.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $596.44 / $916.67 / $1,613.90	Professional		$596.44	$916.67	$1,613.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $697.74 / $930.10 / $1,754.64	Professional		$697.74	$930.10	$1,754.64
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,105.57 / $2,105.57 / $2,105.57	Professional	22	$2,105.57	$2,105.57	$2,105.57
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $28.07 / $28.07 / $28.07	Professional	AS	$28.07	$28.07	$28.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,363.12 / $2,363.12 / $3,250.00	Facility		$2,363.12	$2,363.12	$3,250.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $798.22 / $946.47 / $1,122.45	Professional		$798.22	$946.47	$1,122.45
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 $504.85 / $786.13 / $1,444.66	Professional		$504.85	$786.13	$1,444.66