Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $851.00 / $1,321.19	Facility		$416.78	$851.00	$1,321.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Professional		$416.78	$416.78	$416.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.42 / $416.78 / $534.45	Facility		$271.42	$416.78	$534.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.69 / $166.71 / $516.79	Professional		$141.69	$166.71	$516.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $604.33 / $895.78	Facility		$416.78	$604.33	$895.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $500.14 / $541.80	Professional		$416.78	$500.14	$541.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $622.66 / $916.92 / $1,309.59	Facility		$622.66	$916.92	$1,309.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $683.52 / $1,008.61 / $2,345.28	Professional		$683.52	$1,008.61	$2,345.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $375.10 / $658.72 / $3,247.32	Professional		$375.10	$658.72	$3,247.32
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,123.17 / $2,478.14 / $2,932.00	Facility		$2,123.17	$2,478.14	$2,932.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $562.65 / $743.95	Professional		$416.78	$562.65	$743.95
United Facility/Professional Facility Modifier Low / Median / High Price $375.10 / $375.10 / $375.10	Facility		$375.10	$375.10	$375.10
United Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $249.60 / $757.33	Professional		$175.05	$249.60	$757.33