Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.93 / $104.88 / $357.50	Facility		$51.93	$104.88	$357.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $132.11 / $269.25 / $299.19	Facility	25	$132.11	$269.25	$299.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.43 / $65.09 / $137.31	Professional		$41.43	$65.09	$137.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $56.21 / $71.43 / $144.29	Professional	25	$56.21	$71.43	$144.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $88.78 / $125.60	Professional		$65.76	$88.78	$125.60
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $65.76 / $98.64 / $130.05	Professional	25	$65.76	$98.64	$130.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $74.15 / $138.04	Professional		$46.40	$74.15	$138.04
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $59.67 / $59.67 / $59.67	Professional	25	$59.67	$59.67	$59.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.45 / $63.76 / $88.10	Facility		$46.45	$63.76	$88.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $82.23 / $107.14	Professional		$65.76	$82.23	$107.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $144.00 / $265.00	Facility		$85.00	$144.00	$265.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.18 / $76.95 / $138.40	Professional		$49.18	$76.95	$138.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.09 / $80.56 / $154.34	Professional		$50.09	$80.56	$154.34
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $145.22 / $145.22 / $149.94	Facility		$145.22	$145.22	$149.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $73.12 / $125.29	Professional		$42.93	$73.12	$125.29
United Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $84.95 / $141.44	Professional		$65.56	$84.95	$141.44