Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.35 / $196.66 / $298.64	Facility		$148.35	$196.66	$298.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $166.98 / $310.51	Professional		$133.94	$166.98	$310.51
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $54.70 / $166.34 / $305.25	Professional	25	$54.70	$166.34	$305.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.68 / $175.67 / $291.77	Professional		$150.68	$175.67	$291.77
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $152.76 / $241.58 / $298.70	Professional	25	$152.76	$241.58	$298.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.91 / $192.94 / $324.83	Professional		$146.91	$192.94	$324.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.71 / $215.99 / $297.64	Facility		$169.71	$215.99	$297.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $152.76 / $190.28 / $243.55	Professional		$152.76	$190.28	$243.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $341.08	Professional		$147.60	$147.60	$341.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $152.76 / $160.88 / $582.00	Professional		$152.76	$160.88	$582.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $152.76 / $215.47 / $303.70	Professional		$152.76	$215.47	$303.70
United Facility/Professional Professional Modifier Low / Median / High Price $152.41 / $204.98 / $328.47	Professional		$152.41	$204.98	$328.47