Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.07 / $871.20 / $5,063.00	Facility		$93.07	$871.20	$5,063.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $72.98 / $164.76	Professional		$32.86	$72.98	$164.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $60.30 / $184.72	Professional		$22.07	$60.30	$184.72
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 $30.69 / $69.47 / $166.24	Professional		$30.69	$69.47	$166.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.29 / $40.98 / $68.73	Facility		$33.29	$40.98	$68.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.71 / $106.38 / $113.01	Professional		$88.71	$106.38	$113.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.15 / $34.15 / $76.84	Facility		$34.15	$34.15	$76.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.09 / $54.54 / $156.38	Professional		$23.09	$54.54	$156.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $70.54 / $115.32	Professional		$30.74	$70.54	$115.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.27 / $63.18 / $178.91	Professional		$34.27	$63.18	$178.91
United Facility/Professional Facility Modifier Low / Median / High Price $353.00 / $1,580.00 / $2,665.00	Facility		$353.00	$1,580.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $84.06 / $147.07	Professional		$56.22	$84.06	$147.07