Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.11 / $143.88 / $271.50	Facility		$117.11	$143.88	$271.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $127.37 / $230.00	Professional		$97.00	$127.37	$230.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $110.94 / $130.07 / $200.00	Professional	25	$110.94	$130.07	$200.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.96 / $143.94 / $235.47	Professional		$119.96	$143.94	$235.47
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $119.96 / $190.02 / $235.47	Professional	25	$119.96	$190.02	$235.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.30 / $132.24 / $249.95	Professional		$102.30	$132.24	$249.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.38 / $169.76 / $234.64	Facility		$133.38	$169.76	$234.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.96 / $149.53 / $191.39	Professional		$119.96	$149.53	$191.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $251.13	Professional		$116.36	$116.36	$251.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.96 / $126.83 / $319.61	Professional		$119.96	$126.83	$319.61
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $77.63 / $77.63 / $86.81	Professional	52	$77.63	$77.63	$86.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $119.96 / $169.48 / $236.64	Professional		$119.96	$169.48	$236.64
United Facility/Professional Professional Modifier Low / Median / High Price $102.87 / $138.60 / $243.81	Professional		$102.87	$138.60	$243.81