Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.26 / $2,987.00 / $6,915.00	Facility		$178.26	$2,987.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.38 / $178.26 / $295.98	Professional		$130.38	$178.26	$295.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.49 / $134.49 / $134.49	Professional		$134.49	$134.49	$134.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $775.91 / $2,557.00 / $5,240.56	Facility		$775.91	$2,557.00	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.85 / $200.63 / $382.36	Professional		$140.85	$200.63	$382.36
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $211.27 / $300.94 / $573.54	Professional	50	$211.27	$300.94	$573.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $251.33 / $306.14 / $74,999.25	Facility		$251.33	$306.14	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.60 / $109.51 / $411.00	Facility		$87.60	$109.51	$411.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.77 / $215.74 / $382.10	Professional		$140.77	$215.74	$382.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.14 / $232.54 / $1,164.84	Professional		$167.14	$232.54	$1,164.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $236.53 / $236.53 / $239.31	Professional		$236.53	$236.53	$239.31
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 $147.36 / $191.17 / $341.56	Professional		$147.36	$191.17	$341.56