Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $223.87 / $416.87	Professional		$100.00	$223.87	$416.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $151.36 / $208.93	Facility		$128.82	$151.36	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $151.36	Professional		$100.00	$117.49	$151.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $275.42	Professional		$74.13	$112.20	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $426.58 / $489.78	Facility		$371.54	$426.58	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $446.68 / $741.31	Professional		$302.00	$446.68	$741.31