Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.94 / $28.84 / $79.43	Facility		$7.94	$28.84	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $16.60 / $30.90	Professional		$7.94	$16.60	$30.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $0.30 / $17.38 / $17.38	Professional	25	$0.30	$17.38	$17.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $17.38 / $25.70	Professional		$13.49	$17.38	$25.70
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $16.98 / $16.98 / $16.98	Professional	25	$16.98	$16.98	$16.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $15.14 / $23.44	Professional		$8.71	$15.14	$23.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $12.30 / $16.22	Facility		$9.12	$12.30	$16.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.05 / $25.12	Professional		$15.85	$19.05	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $14.13	Facility		$14.13	$14.13	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $15.85 / $19.05	Professional		$15.85	$15.85	$19.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $19.05 / $30.20	Professional		$8.13	$19.05	$30.20
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $5.37 / $6.03 / $11.75	Professional	52	$5.37	$6.03	$11.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $18.62 / $38.02	Professional		$8.51	$18.62	$38.02
United Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $18.62 / $21.88	Facility		$10.00	$18.62	$21.88
United Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $16.98 / $30.90	Professional		$9.33	$16.98	$30.90