Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $162.18	Professional		$89.13	$109.65	$162.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $177.83	Professional		$100.00	$104.71	$177.83
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	25	$120.23	$120.23	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $281.84	Professional		$112.20	$141.25	$281.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $147.91	Facility		$125.89	$125.89	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $128.82 / $295.12	Professional		$125.89	$128.82	$295.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $269.15	Professional		$134.90	$165.96	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $251.19	Professional		$95.50	$131.83	$251.19