Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $848.91 / $4,817.00 / $7,631.00	Facility		$848.91	$4,817.00	$7,631.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,291.00 / $6,333.60 / $13,554.00	Facility	50	$6,291.00	$6,333.60	$13,554.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.99 / $753.91 / $1,254.34	Professional		$519.99	$753.91	$1,254.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $981.92 / $2,248.29 / $2,488.94	Professional	50	$981.92	$2,248.29	$2,488.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $551.69 / $551.69 / $1,262.93	Professional		$551.69	$551.69	$1,262.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,180.36 / $1,216.98 / $1,599.62	Professional	50	$1,180.36	$1,216.98	$1,599.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $992.53 / $2,669.65 / $5,084.83	Facility		$992.53	$2,669.65	$5,084.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $579.04 / $778.77 / $1,441.39	Professional		$579.04	$778.77	$1,441.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $868.57 / $1,168.15 / $2,162.08	Professional	50	$868.57	$1,168.15	$2,162.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $996.90 / $1,209.90 / $74,999.25	Facility		$996.90	$1,209.90	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.00 / $1,119.77 / $1,410.08	Facility		$778.00	$1,119.77	$1,410.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.94 / $905.67 / $1,724.34	Professional		$602.94	$905.67	$1,724.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $660.55 / $926.37 / $4,630.55	Professional		$660.55	$926.37	$4,630.55
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,518.72 / $1,518.72 / $1,879.42	Professional	22	$1,518.72	$1,518.72	$1,879.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $829.09 / $1,062.61 / $2,071.57	Professional		$829.09	$1,062.61	$2,071.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,180.00 / $4,581.00 / $7,647.00	Facility		$1,180.00	$4,581.00	$7,647.00
United Facility/Professional Professional Modifier Low / Median / High Price $679.98 / $952.28 / $1,697.70	Professional		$679.98	$952.28	$1,697.70