Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.45 / $203.15 / $573.75	Facility		$78.45	$203.15	$573.75
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $287.79 / $428.91 / $713.66	Facility	25	$287.79	$428.91	$713.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.83 / $102.93 / $243.00	Professional		$58.83	$102.93	$243.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $55.80 / $115.68 / $249.08	Professional	25	$55.80	$115.68	$249.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.85 / $160.62 / $227.25	Professional		$100.85	$160.62	$227.25
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $116.00 / $165.52 / $233.24	Professional	25	$116.00	$165.52	$233.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.37 / $121.42 / $237.84	Professional		$84.37	$121.42	$237.84
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $76.31 / $76.31 / $76.31	Professional	25	$76.31	$76.31	$76.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.24 / $130.62 / $182.54	Facility		$96.24	$130.62	$182.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $147.68 / $193.68	Professional		$118.14	$147.68	$193.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $144.00 / $265.00	Facility		$115.00	$144.00	$265.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.19 / $119.05 / $209.35	Professional		$77.19	$119.05	$209.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.15 / $150.76 / $276.80	Professional		$96.15	$150.76	$276.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $174.45 / $174.45 / $180.13	Facility		$174.45	$174.45	$180.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.99 / $141.53 / $224.20	Professional		$87.99	$141.53	$224.20
United Facility/Professional Professional Modifier Low / Median / High Price $88.53 / $122.01 / $211.35	Professional		$88.53	$122.01	$211.35