Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $147.91 / $501.19	Facility		$74.13	$147.91	$501.19
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $245.47 / $316.23 / $426.58	Facility	25	$245.47	$316.23	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $251.19	Professional		$69.18	$107.15	$251.19
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.44 / $117.49 / $269.15	Professional	25	$72.44	$117.49	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $173.78	Professional		$83.18	$112.20	$173.78
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $89.13 / $114.82 / $177.83	Professional	25	$89.13	$114.82	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $181.97	Professional		$75.86	$109.65	$181.97
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	25	$89.13	$89.13	$89.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $112.20 / $158.49	Facility		$83.18	$112.20	$158.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $165.96	Professional		$102.33	$123.03	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $144.54 / $251.19	Facility		$114.82	$144.54	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $190.55	Professional		$79.43	$112.20	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $223.87	Professional		$72.44	$123.03	$223.87
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $457.09 / $457.09	Facility		$173.78	$457.09	$457.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $223.87	Professional		$85.11	$134.90	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $93.33 / $109.65	Facility		$69.18	$93.33	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $169.82	Professional		$70.79	$104.71	$169.82