Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.75 / $3,132.42 / $6,858.00	Facility		$695.75	$3,132.42	$6,858.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,889.18 / $3,535.50 / $13,132.16	Facility	50	$2,889.18	$3,535.50	$13,132.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $391.88 / $512.49 / $1,132.46	Professional		$391.88	$512.49	$1,132.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,793.70 / $1,884.06 / $1,957.14	Professional	50	$1,793.70	$1,884.06	$1,957.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.70 / $556.01 / $830.16	Professional		$267.70	$556.01	$830.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $387.82 / $573.49 / $957.57	Professional	50	$387.82	$573.49	$957.57
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 $410.72 / $624.07 / $1,187.24	Professional		$410.72	$624.07	$1,187.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $616.08 / $936.11 / $1,780.86	Professional	50	$616.08	$936.11	$1,780.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $457.30 / $636.48 / $1,089.69	Facility		$457.30	$636.48	$1,089.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $410.13 / $533.16 / $574.17	Professional		$410.13	$533.16	$574.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $742.64 / $742.64 / $1,272.50	Facility		$742.64	$742.64	$1,272.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.10 / $679.62 / $1,196.93	Professional		$438.10	$679.62	$1,196.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $505.68 / $670.71 / $1,447.91	Professional		$505.68	$670.71	$1,447.91
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,525.98 / $1,525.98 / $1,551.72	Professional	22	$1,525.98	$1,525.98	$1,551.72
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 $587.11 / $700.16 / $827.21	Professional		$587.11	$700.16	$827.21
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 $383.13 / $574.70 / $1,143.85	Professional		$383.13	$574.70	$1,143.85