Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.63 / $856.51 / $1,475.00	Facility		$59.63	$856.51	$1,475.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $651.07 / $1,227.22 / $1,350.71	Facility	25	$651.07	$1,227.22	$1,350.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.57 / $64.93 / $136.11	Professional		$52.57	$64.93	$136.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $62.47 / $136.11 / $496.40	Professional	25	$62.47	$136.11	$496.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $118.25 / $203.61	Professional		$70.95	$118.25	$203.61
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $68.92 / $117.20 / $252.00	Professional	25	$68.92	$117.20	$252.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $747.88 / $2,486.30 / $2,736.80	Facility		$747.88	$2,486.30	$2,736.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.79 / $79.02 / $155.60	Professional		$62.79	$79.02	$155.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.08 / $98.65 / $172.30	Facility		$81.08	$98.65	$172.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $83.01 / $158.61	Professional		$66.41	$83.01	$158.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.35 / $85.89 / $163.24	Professional		$61.35	$85.89	$163.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $96.43 / $223.62	Professional		$68.88	$96.43	$223.62
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,274.00 / $1,274.00 / $1,274.00	Facility		$1,274.00	$1,274.00	$1,274.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $86.45 / $131.59	Professional		$68.88	$86.45	$131.59
United Facility/Professional Professional Modifier Low / Median / High Price $59.73 / $74.37 / $133.35	Professional		$59.73	$74.37	$133.35