Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $888.12 / $4,592.00 / $6,915.00	Facility		$888.12	$4,592.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $577.46 / $802.21 / $1,290.90	Professional		$577.46	$802.21	$1,290.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $409.66 / $488.44 / $1,325.55	Professional		$409.66	$488.44	$1,325.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $875.94 / $2,446.00 / $5,084.83	Facility		$875.94	$2,446.00	$5,084.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $619.33 / $847.78 / $1,580.83	Professional		$619.33	$847.78	$1,580.83
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $928.99 / $1,271.67 / $2,371.23	Professional	50	$928.99	$1,271.67	$2,371.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,095.44 / $1,327.58 / $74,999.25	Facility		$1,095.44	$1,327.58	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $1,119.77 / $1,410.08	Facility		$630.00	$1,119.77	$1,410.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $622.12 / $951.20 / $1,809.26	Professional		$622.12	$951.20	$1,809.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.79 / $1,008.40 / $5,085.97	Professional		$724.79	$1,008.40	$5,085.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $907.38 / $1,165.57 / $2,276.28	Professional		$907.38	$1,165.57	$2,276.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,214.00 / $4,500.00 / $6,995.00	Facility		$1,214.00	$4,500.00	$6,995.00
United Facility/Professional Professional Modifier Low / Median / High Price $706.95 / $936.84 / $1,697.81	Professional		$706.95	$936.84	$1,697.81