Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.30 / $1,571.00 / $6,178.00	Facility		$179.30	$1,571.00	$6,178.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,710.50 / $3,493.34 / $7,542.40	Facility	25	$1,710.50	$3,493.34	$7,542.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.23 / $236.15 / $586.38	Professional		$172.23	$236.15	$586.38
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $43.52 / $314.62 / $871.41	Professional	25	$43.52	$314.62	$871.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.13 / $365.04 / $480.16	Professional		$202.13	$365.04	$480.16
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $222.34 / $385.08 / $468.44	Professional	25	$222.34	$385.08	$468.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $2,311.38 / $2,352.29	Facility		$1,760.00	$2,311.38	$2,352.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.72 / $303.82 / $548.50	Professional		$205.72	$303.82	$548.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $222.32 / $290.37 / $404.26	Facility		$222.32	$290.37	$404.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.32 / $314.14 / $413.90	Professional		$251.32	$314.14	$413.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $286.33 / $286.33	Facility		$286.33	$286.33	$286.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.64 / $307.76 / $565.97	Professional		$214.64	$307.76	$565.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $238.52 / $331.46 / $638.64	Professional		$238.52	$331.46	$638.64
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,932.00 / $2,932.00 / $2,932.00	Facility		$2,932.00	$2,932.00	$2,932.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $207.41 / $331.10 / $513.21	Professional		$207.41	$331.10	$513.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,289.78 / $1,289.78 / $1,289.78	Facility		$1,289.78	$1,289.78	$1,289.78
United Facility/Professional Professional Modifier Low / Median / High Price $245.35 / $313.50 / $527.97	Professional		$245.35	$313.50	$527.97