Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.98 / $51.71 / $81.11	Facility		$29.98	$51.71	$81.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.82 / $58.03 / $100.64	Professional		$30.82	$58.03	$100.64
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $40.39 / $82.66 / $135.05	Professional	25	$40.39	$82.66	$135.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $80.69 / $88.23	Professional		$47.52	$80.69	$88.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $46.11 / $85.61 / $88.23	Professional	25	$46.11	$85.61	$88.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $46.81 / $94.09	Professional		$37.90	$46.81	$94.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.84 / $64.55 / $95.04	Facility		$50.84	$64.55	$95.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $63.69 / $76.12	Professional		$56.16	$63.69	$76.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $52.04 / $92.64	Professional		$33.86	$52.04	$92.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $66.53 / $118.01	Professional		$47.52	$66.53	$118.01
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $125.65 / $125.65 / $125.65	Professional	22	$125.65	$125.65	$125.65
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $3.35 / $3.35 / $3.35	Professional	80	$3.35	$3.35	$3.35
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $1.68 / $1.68 / $1.68	Professional	AS	$1.68	$1.68	$1.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.83 / $62.83 / $84.13	Professional		$42.83	$62.83	$84.13
United Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $45.86 / $90.06	Professional		$38.09	$45.86	$90.06