Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.67 / $2,987.00 / $6,915.00	Facility		$194.67	$2,987.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.67 / $240.00 / $464.68	Professional		$100.67	$240.00	$464.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.06 / $365.38 / $495.16	Professional		$266.06	$365.38	$495.16
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 $113.19 / $155.27 / $299.29	Professional		$113.19	$155.27	$299.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $169.78 / $232.90 / $448.93	Professional	50	$169.78	$232.90	$448.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $195.23 / $238.44 / $74,999.25	Facility		$195.23	$238.44	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.80 / $202.25 / $411.00	Facility		$161.80	$202.25	$411.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.73 / $275.66 / $629.42	Professional		$120.73	$275.66	$629.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $338.62 / $903.26	Professional		$130.16	$338.62	$903.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.87 / $240.03 / $527.51	Professional		$101.87	$240.03	$527.51
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 $185.79 / $326.70 / $592.79	Professional		$185.79	$326.70	$592.79