Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.19 / $159.44 / $432.37	Facility		$118.19	$159.44	$432.37
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $253.58 / $355.50 / $539.50	Facility	25	$253.58	$355.50	$539.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.28 / $154.37 / $327.60	Professional		$106.28	$154.37	$327.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $109.64 / $175.27 / $338.11	Professional	25	$109.64	$175.27	$338.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.38 / $222.45 / $304.72	Professional		$152.38	$222.45	$304.72
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $155.96 / $233.94 / $304.72	Professional	25	$155.96	$233.94	$304.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.65 / $171.26 / $321.55	Professional		$125.65	$171.26	$321.55
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $125.65 / $125.65 / $125.65	Professional	25	$125.65	$125.65	$125.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $132.54 / $179.52 / $251.36	Facility		$132.54	$179.52	$251.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $153.88 / $192.23 / $253.42	Professional		$153.88	$192.23	$253.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $150.00 / $265.00	Facility		$115.00	$150.00	$265.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.60 / $181.07 / $319.89	Professional		$124.60	$181.07	$319.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.93 / $196.96 / $365.05	Professional		$142.93	$196.96	$365.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $250.25 / $250.25 / $254.17	Facility		$250.25	$250.25	$254.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $121.61 / $192.32 / $295.44	Professional		$121.61	$192.32	$295.44
United Facility/Professional Facility Modifier Low / Median / High Price $126.11 / $155.22 / $188.95	Facility		$126.11	$155.22	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $142.85 / $183.81 / $317.76	Professional		$142.85	$183.81	$317.76