Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $751.73 / $4,592.00 / $6,915.00	Facility		$751.73	$4,592.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $471.33 / $719.10 / $1,210.83	Professional		$471.33	$719.10	$1,210.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,266.70 / $1,266.70 / $1,266.70	Professional		$1,266.70	$1,266.70	$1,266.70
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 $515.04 / $701.64 / $1,308.32	Professional		$515.04	$701.64	$1,308.32
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $772.57 / $1,052.46 / $1,962.48	Professional	50	$772.57	$1,052.46	$1,962.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $900.48 / $1,098.44 / $74,999.25	Facility		$900.48	$1,098.44	$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 $543.36 / $871.84 / $1,703.47	Professional		$543.36	$871.84	$1,703.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $599.67 / $924.83 / $4,192.64	Professional		$599.67	$924.83	$4,192.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,109.80 / $1,109.80 / $1,113.83	Professional		$1,109.80	$1,109.80	$1,113.83
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 $693.27 / $902.99 / $1,584.03	Professional		$693.27	$902.99	$1,584.03