Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $107.15 / $141.25	Facility		$93.33	$107.15	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $190.55	Professional		$93.33	$120.23	$190.55
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	25	$128.82	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $123.03 / $169.82	Professional		$100.00	$123.03	$169.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.82 / $117.49 / $131.83	Professional	25	$114.82	$117.49	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $213.80	Professional		$89.13	$138.04	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $371.54	Facility		$186.21	$186.21	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $190.55	Professional		$102.33	$141.25	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $213.80	Professional		$134.90	$165.96	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $323.59	Professional		$104.71	$144.54	$323.59