Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $733.67 / $1,236.92 / $4,007.42	Facility		$733.67	$1,236.92	$4,007.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $734.15 / $931.75	Professional		$733.67	$734.15	$931.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $734.16 / $734.16 / $734.16	Professional		$734.16	$734.16	$734.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $733.67 / $1,173.86 / $2,692.57	Facility		$733.67	$1,173.86	$2,692.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $748.34	Professional		$733.67	$733.67	$748.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $733.67 / $733.67 / $1,174.64	Facility		$733.67	$733.67	$1,174.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $734.15 / $1,173.86	Professional		$733.67	$734.15	$1,173.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.14 / $692.14 / $733.67	Facility		$692.14	$692.14	$733.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $733.67 / $934.38	Professional		$733.67	$733.67	$934.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $503.98 / $703.06 / $1,124.90	Professional		$503.98	$703.06	$1,124.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $314.00 / $1,173.85 / $1,511.29	Professional		$314.00	$1,173.85	$1,511.29
United Facility/Professional Professional Modifier Low / Median / High Price $733.67 / $742.40 / $939.10	Professional		$733.67	$742.40	$939.10