Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.13 / $81.11 / $100.58	Facility		$56.13	$81.11	$100.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.13 / $77.94 / $179.09	Professional		$56.13	$77.94	$179.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.44 / $129.46 / $146.71	Professional		$74.44	$129.46	$146.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.28 / $80.61 / $154.16	Professional		$64.28	$80.61	$154.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.09 / $104.22 / $153.62	Facility		$82.09	$104.22	$153.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.70 / $102.80 / $122.91	Professional		$90.70	$102.80	$122.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.38 / $94.01 / $156.30	Professional		$60.38	$94.01	$156.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.81 / $107.53 / $193.56	Professional		$76.81	$107.53	$193.56
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $203.09 / $203.09 / $203.09	Professional	22	$203.09	$203.09	$203.09
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $5.42 / $5.42 / $5.42	Professional	80	$5.42	$5.42	$5.42
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $2.71 / $2.71 / $2.71	Professional	AS	$2.71	$2.71	$2.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $101.21 / $139.12	Professional		$69.13	$101.21	$139.12
United Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $82.04 / $148.69	Professional		$65.48	$82.04	$148.69