Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $92.36 / $162.65	Facility		$51.31	$92.36	$162.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $94.12	Professional		$51.31	$51.31	$94.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.66 / $25.66 / $25.66	Professional		$25.66	$25.66	$25.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.42 / $55.72 / $67.22	Facility		$33.42	$55.72	$67.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.42 / $20.52 / $63.61	Professional		$16.42	$20.52	$63.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $74.40 / $110.28	Facility		$51.31	$74.40	$110.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $61.57 / $66.70	Professional		$51.31	$61.57	$66.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.68 / $80.70 / $145.37	Facility		$57.68	$80.70	$145.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.80 / $48.70 / $133.91	Professional		$25.80	$48.70	$133.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $59.01 / $399.79	Professional		$46.18	$59.01	$399.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,617.76 / $1,755.58 / $2,164.00	Facility		$1,617.76	$1,755.58	$2,164.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $63.11 / $91.59	Professional		$49.92	$63.11	$91.59
United Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $51.31 / $78.12	Professional		$30.79	$51.31	$78.12