Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $519.28 / $3,391.00 / $6,915.00	Facility		$519.28	$3,391.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.81 / $420.84 / $833.14	Professional		$316.81	$420.84	$833.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $457.89 / $457.89 / $457.89	Professional		$457.89	$457.89	$457.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.08 / $2,292.94 / $5,240.56	Facility		$741.08	$2,292.94	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.56 / $523.48 / $1,001.01	Professional		$344.56	$523.48	$1,001.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $486.08 / $486.08 / $486.08	Facility		$486.08	$486.08	$486.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.06 / $424.06 / $1,272.50	Facility		$424.06	$424.06	$1,272.50
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $263.31 / $263.31 / $263.31	Facility	62	$263.31	$263.31	$263.31
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $42.13 / $42.13 / $42.13	Facility	AS	$42.13	$42.13	$42.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $357.21 / $568.15 / $991.24	Professional		$357.21	$568.15	$991.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $428.55 / $596.24 / $1,077.67	Professional		$428.55	$596.24	$1,077.67
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $404.13 / $404.13 / $404.13	Professional	62	$404.13	$404.13	$404.13
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $34.49 / $34.49 / $34.49	Professional	80	$34.49	$34.49	$34.49
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $17.23 / $17.23 / $17.23	Professional	AS	$17.23	$17.23	$17.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $505.22 / $598.77 / $689.40	Professional		$505.22	$598.77	$689.40
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 $311.57 / $466.91 / $940.02	Professional		$311.57	$466.91	$940.02