Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $741.31 / $1,479.11	Facility		$295.12	$741.31	$1,479.11
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $645.65 / $1,230.27 / $1,348.96	Facility	25	$645.65	$1,230.27	$1,348.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $371.54	Professional		$52.48	$70.79	$371.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $141.25 / $501.19	Professional	25	$63.10	$141.25	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $147.91	Professional		$67.61	$100.00	$147.91
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.61 / $102.33 / $141.25	Professional	25	$67.61	$102.33	$141.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $2,511.89 / $2,754.23	Facility		$741.31	$2,511.89	$2,754.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $74.13 / $131.83	Professional		$63.10	$74.13	$131.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $102.33 / $151.36	Facility		$83.18	$102.33	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $162.18	Professional		$67.61	$87.10	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $162.18	Professional		$61.66	$85.11	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $223.87	Professional		$70.79	$97.72	$223.87
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $165.96	Professional		$72.44	$117.49	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $74.13 / $125.89	Professional		$58.88	$74.13	$125.89