Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $147.91 / $338.84	Facility		$66.07	$147.91	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $204.17	Professional		$57.54	$87.10	$204.17
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $19.05 / $19.05 / $19.05	Professional	CQ	$19.05	$19.05	$19.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	CQ	$120.23	$120.23	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $85.11 / $144.54	Professional		$69.18	$85.11	$144.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $138.04 / $162.18	Facility		$97.72	$138.04	$162.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $109.65 / $218.78	Professional		$95.50	$109.65	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $70.79 / $97.72	Facility		$60.26	$70.79	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $77.62 / $158.49	Professional		$52.48	$77.62	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $144.54	Professional		$81.28	$97.72	$144.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $251.19 / $389.05	Facility		$173.78	$251.19	$389.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $141.25	Professional		$120.23	$131.83	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $134.90	Professional		$66.07	$83.18	$134.90