Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.79 / $132.07 / $863.10	Facility		$48.79	$132.07	$863.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $62.81 / $104.92	Professional		$48.79	$62.81	$104.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.10 / $83.37 / $253.86	Facility		$50.10	$83.37	$253.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $66.03 / $143.96	Professional		$22.63	$66.03	$143.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.37 / $102.72 / $157.75	Facility		$73.37	$102.72	$157.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.37 / $88.04 / $95.38	Professional		$73.37	$88.04	$95.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $119.23 / $204.06	Facility		$66.00	$119.23	$204.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $98.55 / $283.98	Professional		$36.56	$98.55	$283.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.37 / $100.52 / $571.15	Professional		$73.37	$100.52	$571.15
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $605.63 / $727.46 / $905.00	Facility		$605.63	$727.46	$905.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.78 / $102.72 / $135.72	Professional		$88.78	$102.72	$135.72
United Facility/Professional Professional Modifier Low / Median / High Price $30.82 / $44.02 / $128.43	Professional		$30.82	$44.02	$128.43