Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.28 / $2,800.00 / $6,915.00	Facility		$126.28	$2,800.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $180.76 / $338.79	Professional		$72.84	$180.76	$338.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.90 / $239.90 / $313.44	Professional		$239.90	$239.90	$313.44
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 $66.41 / $106.76 / $200.47	Professional		$66.41	$106.76	$200.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $99.61 / $160.13 / $300.70	Professional	50	$99.61	$160.13	$300.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.36 / $139.88 / $74,999.25	Facility		$117.36	$139.88	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.34 / $167.93 / $411.00	Facility		$134.34	$167.93	$411.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.93 / $180.37 / $405.54	Professional		$82.93	$180.37	$405.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $223.90 / $535.60	Professional		$76.37	$223.90	$535.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $229.37 / $278.63	Professional		$87.00	$229.37	$278.63
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 $175.61 / $243.83 / $394.74	Professional		$175.61	$243.83	$394.74