Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.53 / $219.32 / $2,011.10	Facility		$132.53	$219.32	$2,011.10
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $422.82 / $468.49 / $783.71	Facility	25	$422.82	$468.49	$783.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.99 / $189.25 / $419.00	Professional		$139.99	$189.25	$419.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $167.00 / $240.12 / $468.00	Professional	25	$167.00	$240.12	$468.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $184.35 / $311.33 / $396.52	Professional		$184.35	$311.33	$396.52
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $206.42 / $324.45 / $394.26	Professional	25	$206.42	$324.45	$394.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.92 / $223.47 / $418.74	Professional		$170.92	$223.47	$418.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $180.43 / $244.12 / $342.00	Facility		$180.43	$244.12	$342.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $203.53 / $253.69 / $335.19	Professional		$203.53	$253.69	$335.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $150.00 / $287.20	Facility		$115.00	$150.00	$287.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $230.60 / $416.40	Professional		$161.63	$230.60	$416.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.35 / $265.33 / $487.89	Professional		$188.35	$265.33	$487.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.05 / $262.75 / $389.67	Professional		$168.05	$262.75	$389.67
United Facility/Professional Professional Modifier Low / Median / High Price $181.15 / $232.00 / $404.10	Professional		$181.15	$232.00	$404.10
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $88.00 / $90.00	Professional	25	$80.00	$88.00	$90.00