Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $858.50 / $858.50 / $2,039.29	Facility		$858.50	$858.50	$2,039.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $858.50 / $996.99 / $1,436.12	Professional		$858.50	$996.99	$1,436.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,337.76 / $1,337.76 / $1,337.76	Professional		$1,337.76	$1,337.76	$1,337.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,807.78 / $2,530.89 / $6,634.55	Facility		$1,807.78	$2,530.89	$6,634.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,124.88 / $1,526.48 / $2,886.01	Professional		$1,124.88	$1,526.48	$2,886.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,509.73 / $1,593.87 / $3,344.39	Facility		$1,509.73	$1,593.87	$3,344.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,536.61 / $1,536.61 / $1,536.61	Professional		$1,536.61	$1,536.61	$1,536.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,037.25 / $1,037.25 / $1,037.25	Facility		$1,037.25	$1,037.25	$1,037.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $757.19 / $1,037.25 / $2,059.13	Professional		$757.19	$1,037.25	$2,059.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,373.91 / $1,807.78 / $2,939.00	Professional		$1,373.91	$1,807.78	$2,939.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3,073.23 / $3,134.70 / $3,411.29	Professional		$3,073.23	$3,134.70	$3,411.29
United Facility/Professional Professional Modifier Low / Median / High Price $601.25 / $901.88 / $1,765.41	Professional		$601.25	$901.88	$1,765.41