Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.61 / $4,590.00 / $6,915.00	Facility		$136.61	$4,590.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.68 / $146.69 / $247.73	Professional		$106.68	$146.69	$247.73
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $331.90 / $331.90 / $331.90	Professional	50	$331.90	$331.90	$331.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.32 / $181.32 / $229.98	Professional		$181.32	$181.32	$229.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $169.66 / $169.66 / $169.66	Professional	50	$169.66	$169.66	$169.66
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 $116.97 / $162.90 / $309.29	Professional		$116.97	$162.90	$309.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $175.45 / $244.35 / $463.93	Professional	50	$175.45	$244.35	$463.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $204.39 / $250.01 / $74,999.25	Facility		$204.39	$250.01	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.41 / $100.51 / $411.00	Facility		$80.41	$100.51	$411.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $171.40 / $323.24	Professional		$112.20	$171.40	$323.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $181.43 / $946.49	Professional		$136.47	$181.43	$946.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.79 / $193.65 / $259.94	Professional		$108.79	$193.65	$259.94
United Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $1,550.00 / $2,506.00	Facility		$123.00	$1,550.00	$2,506.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.18 / $163.27 / $289.39	Professional		$125.18	$163.27	$289.39