Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.56 / $171.15 / $3,242.00	Facility		$99.56	$171.15	$3,242.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $86.51 / $86.51 / $86.51	Facility	25	$86.51	$86.51	$86.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $122.02 / $779.96	Professional		$89.98	$122.02	$779.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $106.31 / $652.15 / $2,842.00	Professional	25	$106.31	$652.15	$2,842.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $197.99 / $235.66	Professional		$103.66	$197.99	$235.66
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $136.33 / $198.37 / $222.18	Professional	25	$136.33	$198.37	$222.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,352.29 / $2,352.29 / $2,352.29	Facility		$2,352.29	$2,352.29	$2,352.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.91 / $141.82 / $251.51	Professional		$102.91	$141.82	$251.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.11 / $145.12 / $201.98	Facility		$111.11	$145.12	$201.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.47 / $138.09 / $181.93	Professional		$110.47	$138.09	$181.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.15 / $143.15 / $143.15	Facility		$143.15	$143.15	$143.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.11 / $147.88 / $247.88	Professional		$102.11	$147.88	$247.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.24 / $151.11 / $319.23	Professional		$116.24	$151.11	$319.23
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,932.00 / $2,932.00 / $2,932.00	Facility		$2,932.00	$2,932.00	$2,932.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $156.97 / $223.05	Professional		$103.40	$156.97	$223.05
United Facility/Professional Professional Modifier Low / Median / High Price $109.57 / $138.44 / $230.38	Professional		$109.57	$138.44	$230.38
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $85.00 / $234.81	Professional	25	$80.00	$85.00	$234.81