Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.87 / $136.47 / $215.58	Professional		$114.87	$136.47	$215.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $242.77 / $242.77 / $307.07	Professional		$242.77	$242.77	$307.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.74 / $251.74 / $251.74	Facility		$251.74	$251.74	$251.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.19 / $201.89 / $403.26	Professional		$20.19	$201.89	$403.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.39 / $212.79 / $405.80	Facility		$21.39	$212.79	$405.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $160.47 / $296.69	Professional		$21.39	$160.47	$296.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $160.96 / $226.01	Facility		$160.96	$160.96	$226.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.82 / $160.96 / $274.13	Professional		$136.82	$160.96	$274.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $191.32 / $251.74 / $823.00	Professional		$191.32	$251.74	$823.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.62 / $182.60 / $273.91	Professional		$92.62	$182.60	$273.91