Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $478.63 / $602.56	Facility		$25.70	$478.63	$602.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $645.65 / $1,047.13	Professional		$302.00	$645.65	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier QK Low / Median / High Price $194.98 / $194.98 / $263.03	Professional	QK	$194.98	$194.98	$263.03
Kaiser Permanente Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $194.98 / $263.03	Professional	QX	$194.98	$194.98	$263.03
Kaiser Permanente Facility/Professional Professional Modifier QY Low / Median / High Price $194.98 / $194.98 / $263.03	Professional	QY	$194.98	$194.98	$263.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $8,912.51 / $21,379.62	Facility		$4,897.79	$8,912.51	$21,379.62