Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,659.59 / $4,786.30	Facility		$218.78	$1,659.59	$4,786.30
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,659.59 / $3,467.37 / $7,762.47	Facility	25	$1,659.59	$3,467.37	$7,762.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $812.83	Professional		$173.78	$257.04	$812.83
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $363.08 / $1,174.90	Professional	25	$190.55	$363.08	$1,174.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $436.52	Professional		$186.21	$275.42	$436.52
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $204.17 / $309.03 / $457.09	Professional	25	$204.17	$309.03	$457.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,290.87 / $2,344.23	Facility		$1,778.28	$2,290.87	$2,344.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $512.86	Professional		$223.87	$295.12	$512.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $302.00 / $416.87	Facility		$218.78	$302.00	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $309.03 / $416.87	Professional		$251.19	$309.03	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $501.19	Professional		$213.80	$309.03	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $630.96	Professional		$223.87	$354.81	$630.96
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,951.21 / $20,417.38	Facility		$1,737.80	$2,951.21	$20,417.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $389.05 / $630.96	Professional		$223.87	$389.05	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $457.09	Professional		$213.80	$281.84	$457.09