Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.50 / $124.10 / $210.00	Facility		$109.50	$124.10	$210.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.72 / $153.83 / $242.66	Professional		$119.72	$153.83	$242.66
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $105.00 / $146.00 / $317.29	Professional	25	$105.00	$146.00	$317.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $165.00 / $289.10	Professional		$129.19	$165.00	$289.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.88 / $169.60 / $309.79	Professional		$116.88	$169.60	$309.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.20 / $190.01 / $262.82	Facility		$123.20	$190.01	$262.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $149.78 / $236.02 / $302.72	Professional		$149.78	$236.02	$302.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $162.13 / $276.94	Professional		$70.00	$162.13	$276.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $172.47 / $197.87 / $456.95	Professional		$172.47	$197.87	$456.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $147.00 / $196.55 / $334.83	Professional		$147.00	$196.55	$334.83
United Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $191.76 / $400.00	Professional		$128.77	$191.76	$400.00