Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $221.85 / $3,080.77	Facility		$115.51	$221.85	$3,080.77
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $152.35 / $445.86 / $808.70	Facility	25	$152.35	$445.86	$808.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.51 / $146.19 / $320.00	Professional		$97.51	$146.19	$320.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $85.76 / $176.28 / $370.00	Professional	25	$85.76	$176.28	$370.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.60 / $250.00 / $319.60	Professional		$150.60	$250.00	$319.60
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $167.33 / $256.01 / $327.27	Professional	25	$167.33	$256.01	$327.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.07 / $171.03 / $340.29	Professional		$120.07	$171.03	$340.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $142.30 / $192.97 / $269.54	Facility		$142.30	$192.97	$269.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $166.04 / $207.55 / $272.43	Professional		$166.04	$207.55	$272.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $145.00 / $265.00	Facility		$115.00	$145.00	$265.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.85 / $163.35 / $295.89	Professional		$111.85	$163.35	$295.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.51 / $211.54 / $388.42	Professional		$139.51	$211.54	$388.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $206.22 / $315.08	Professional		$130.69	$206.22	$315.08
United Facility/Professional Professional Modifier Low / Median / High Price $126.08 / $167.23 / $304.45	Professional		$126.08	$167.23	$304.45