Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,161.15 / $5,063.00 / $7,421.00	Facility		$1,161.15	$5,063.00	$7,421.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $817.67 / $1,241.41 / $1,964.99	Professional		$817.67	$1,241.41	$1,964.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,847.27 / $4,687.32 / $4,687.32	Professional	50	$2,847.27	$4,687.32	$4,687.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $989.39 / $1,836.90 / $1,918.46	Professional		$989.39	$1,836.90	$1,918.46
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,150.17 / $1,150.17 / $2,877.70	Professional	50	$1,150.17	$1,150.17	$2,877.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $875.94 / $2,795.56 / $6,271.28	Facility		$875.94	$2,795.56	$6,271.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $890.45 / $1,350.04 / $2,513.03	Professional		$890.45	$1,350.04	$2,513.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,335.67 / $2,025.06 / $3,769.54	Professional	50	$1,335.67	$2,025.06	$3,769.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,698.03 / $2,084.10 / $74,999.25	Facility		$1,698.03	$2,084.10	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $1,732.09 / $2,181.15	Facility		$630.00	$1,732.09	$2,181.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $877.03 / $1,292.22 / $2,682.97	Professional		$877.03	$1,292.22	$2,682.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,088.33 / $1,583.02 / $8,045.10	Professional		$1,088.33	$1,583.02	$8,045.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,543.45 / $1,714.04 / $3,528.46	Professional		$1,543.45	$1,714.04	$3,528.46
United Facility/Professional Facility Modifier Low / Median / High Price $990.00 / $6,000.00 / $8,554.00	Facility		$990.00	$6,000.00	$8,554.00
United Facility/Professional Professional Modifier Low / Median / High Price $854.95 / $1,203.50 / $2,293.67	Professional		$854.95	$1,203.50	$2,293.67