Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $47.86 / $54.95	Facility		$46.77	$47.86	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $47.86 / $57.54	Professional		$46.77	$47.86	$57.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $77.62 / $263.03	Facility		$47.86	$77.62	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $44.67 / $47.86	Facility		$44.67	$44.67	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $53.70	Professional		$47.86	$47.86	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $125.89	Professional		$47.86	$57.54	$125.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $53.70	Professional		$47.86	$47.86	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $93.33 / $131.83	Facility		$47.86	$93.33	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $54.95	Professional		$47.86	$47.86	$54.95