Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $4,168.69 / $7,413.10	Facility		$426.58	$4,168.69	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility	50	$1,258.93	$1,258.93	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $645.65	Professional		$204.17	$309.03	$645.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $331.13 / $758.58 / $1,023.29	Professional	50	$331.13	$758.58	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $436.52	Professional		$208.93	$269.15	$436.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $234.42 / $371.54 / $707.95	Professional	50	$234.42	$371.54	$707.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $2,511.89 / $3,548.13	Facility		$831.76	$2,511.89	$3,548.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $323.59 / $537.03	Professional		$229.09	$323.59	$537.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $346.74 / $489.78 / $794.33	Professional	50	$346.74	$489.78	$794.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $269.15 / $288.40	Facility		$194.98	$269.15	$288.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $316.23	Professional		$309.03	$309.03	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $165.96 / $407.38	Facility		$131.83	$165.96	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $389.05 / $645.65	Professional		$213.80	$389.05	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $346.74 / $1,584.89	Professional		$199.53	$346.74	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $245.47 / $288.40 / $446.68	Professional	54	$245.47	$288.40	$446.68
Kaiser Permanente Facility/Professional Professional Modifier 55 Low / Median / High Price $17.38 / $20.89 / $32.36	Professional	55	$17.38	$20.89	$32.36
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $309.03 / $371.54	Professional		$239.88	$309.03	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $2,041.74 / $3,467.37	Facility		$407.38	$2,041.74	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $549.54	Professional		$213.80	$331.13	$549.54