Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.93 / $287.85 / $1,021.36	Facility		$84.93	$287.85	$1,021.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.93 / $98.00 / $341.18	Professional		$84.93	$98.00	$341.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.75 / $150.44 / $214.87	Professional		$76.75	$150.44	$214.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.27 / $92.52 / $92.52	Facility		$85.27	$92.52	$92.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $104.16 / $109.94	Professional		$85.27	$104.16	$109.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $89.54 / $174.61	Facility		$86.98	$89.54	$174.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $226.27 / $226.27 / $226.27	Professional		$226.27	$226.27	$226.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $86.98 / $86.98	Facility		$86.98	$86.98	$86.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $86.98 / $86.98	Professional		$86.98	$86.98	$86.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $173.96 / $296.56	Professional		$86.98	$173.96	$296.56
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,574.21 / $2,169.73 / $2,606.31	Facility		$1,574.21	$2,169.73	$2,606.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $232.16 / $253.37	Professional		$165.83	$232.16	$253.37
United Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $107.91	Professional		$85.27	$85.27	$107.91