Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.66 / $3,043.00 / $6,915.00	Facility		$150.66	$3,043.00	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,276.00 / $2,276.00 / $2,276.00	Facility	50	$2,276.00	$2,276.00	$2,276.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.70 / $144.80 / $258.63	Professional		$100.70	$144.80	$258.63
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $150.62 / $365.00 / $658.98	Professional	50	$150.62	$365.00	$658.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.48 / $176.15 / $238.72	Professional		$121.48	$176.15	$238.72
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $221.81 / $264.23 / $358.08	Professional	50	$221.81	$264.23	$358.08
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 $109.16 / $152.71 / $284.75	Professional		$109.16	$152.71	$284.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $163.74 / $229.06 / $427.12	Professional	50	$163.74	$229.06	$427.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $195.30 / $239.60 / $74,999.25	Facility		$195.30	$239.60	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.01 / $90.73 / $114.25	Facility		$84.01	$90.73	$114.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.10 / $163.18 / $313.98	Professional		$110.10	$163.18	$313.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.81 / $159.25 / $908.85	Professional		$130.81	$159.25	$908.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $167.63 / $200.15 / $257.16	Professional		$167.63	$200.15	$257.16
United Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $1,550.00 / $2,665.00	Facility		$107.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $120.42 / $173.36 / $305.95	Professional		$120.42	$173.36	$305.95