Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $532.85 / $1,265.76 / $2,550.00	Facility		$532.85	$1,265.76	$2,550.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $532.85 / $617.22 / $982.51	Professional		$532.85	$617.22	$982.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $830.32 / $830.32 / $1,790.00	Professional		$830.32	$830.32	$1,790.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.06 / $1,570.88 / $4,117.96	Facility		$1,122.06	$1,570.88	$4,117.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $590.27 / $932.96 / $1,791.28	Professional		$590.27	$932.96	$1,791.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $953.75 / $1,099.49 / $2,075.81	Facility		$953.75	$1,099.49	$2,075.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $953.75 / $953.75 / $953.75	Professional		$953.75	$953.75	$953.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $773.33	Facility		$700.00	$700.00	$773.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $700.00 / $1,308.75	Professional		$511.00	$700.00	$1,308.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $852.77 / $1,122.06 / $1,558.67	Professional		$852.77	$1,122.06	$1,558.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,387.23 / $1,402.58 / $1,430.62	Professional		$1,387.23	$1,402.58	$1,430.62
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $480.00	Facility		$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $373.18 / $559.78 / $923.54	Professional		$373.18	$559.78	$923.54