Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.95 / $2,058.90 / $5,063.00	Facility		$108.95	$2,058.90	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.23 / $18.85 / $35.93	Professional		$13.23	$18.85	$35.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.64 / $37.06 / $69.47	Professional	50	$20.64	$37.06	$69.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $6.88 / $7.28 / $17.59	Professional	52	$6.88	$7.28	$17.59
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.75 / $2.83 / $7.89	Professional	53	$2.75	$2.83	$7.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.77 / $26.75 / $28.59	Professional		$13.77	$26.75	$28.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $20.66 / $40.13 / $42.33	Professional	50	$20.66	$40.13	$42.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.25 / $20.89 / $35.35	Professional		$14.25	$20.89	$35.35
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $21.37 / $31.34 / $55.02	Professional	50	$21.37	$31.34	$55.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.20 / $19.57 / $34.13	Facility		$16.20	$19.57	$34.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.01 / $18.05 / $30.75	Professional		$18.01	$18.05	$30.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.01 / $23.14 / $38.01	Professional		$15.01	$23.14	$38.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $19.76 / $153.00	Professional		$15.20	$19.76	$153.00
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $11.58 / $11.58 / $11.58	Professional	52	$11.58	$11.58	$11.58
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $11.58 / $11.58 / $11.58	Professional	53	$11.58	$11.58	$11.58
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $688.80 / $688.80 / $1,574.88	Facility		$688.80	$688.80	$1,574.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $27.13 / $32.13	Professional		$22.95	$27.13	$32.13
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $13.36 / $19.92 / $33.68	Professional		$13.36	$19.92	$33.68