Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.36 / $1,777.46 / $6,726.00	Facility		$171.36	$1,777.46	$6,726.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $917.43 / $4,821.00 / $10,159.78	Facility	50	$917.43	$4,821.00	$10,159.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.19 / $124.14 / $272.54	Professional		$91.19	$124.14	$272.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.79 / $268.95 / $416.01	Professional	50	$35.79	$268.95	$416.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $153.96 / $193.51	Professional		$103.20	$153.96	$193.51
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $161.66 / $230.94 / $288.74	Professional	50	$161.66	$230.94	$288.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $606.69 / $2,085.16 / $3,851.83	Facility		$606.69	$2,085.16	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.08 / $147.72 / $283.39	Professional		$89.08	$147.72	$283.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $133.62 / $221.58 / $425.09	Professional	50	$133.62	$221.58	$425.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $122.74 / $357.70	Facility		$89.01	$122.74	$357.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $142.06 / $142.06 / $142.06	Professional		$142.06	$142.06	$142.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.17 / $73.95 / $411.00	Facility		$59.17	$73.95	$411.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.99 / $199.24 / $380.96	Professional		$103.99	$199.24	$380.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.36 / $153.06 / $716.79	Professional		$102.36	$153.06	$716.79
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $235.36 / $235.36 / $289.08	Professional	22	$235.36	$235.36	$289.08
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $627.66 / $1,276.90 / $1,750.00	Facility		$627.66	$1,276.90	$1,750.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $111.32 / $155.77 / $301.95	Professional		$111.32	$155.77	$301.95
United Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $1,550.00 / $2,665.00	Facility		$107.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $100.12 / $166.46 / $308.39	Professional		$100.12	$166.46	$308.39