Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.36 / $916.22 / $2,694.00	Facility		$101.36	$916.22	$2,694.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $943.08 / $1,352.72 / $2,694.00	Facility	25	$943.08	$1,352.72	$2,694.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.91 / $116.80 / $242.24	Professional		$93.91	$116.80	$242.24
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $119.15 / $235.56 / $765.68	Professional	25	$119.15	$235.56	$765.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.47 / $216.05 / $428.87	Professional		$123.47	$216.05	$428.87
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $120.77 / $208.13 / $428.37	Professional	25	$120.77	$208.13	$428.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,324.39 / $2,486.30 / $2,736.80	Facility		$1,324.39	$2,486.30	$2,736.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.03 / $140.34 / $264.30	Professional		$108.03	$140.34	$264.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.55 / $168.57 / $336.90	Facility		$138.55	$168.57	$336.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $141.69 / $271.33	Professional		$113.36	$141.69	$271.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.01 / $156.88 / $278.69	Professional		$104.01	$156.88	$278.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.59 / $176.39 / $379.85	Professional		$117.59	$176.39	$379.85
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,164.00 / $2,164.00 / $2,164.00	Facility		$2,164.00	$2,164.00	$2,164.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $147.50 / $224.89	Professional		$117.45	$147.50	$224.89
United Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $136.62 / $232.46	Professional		$103.62	$136.62	$232.46