Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $169.82 / $16,595.87	Facility		$104.71	$169.82	$16,595.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $125.89	Professional		$104.71	$104.71	$125.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $169.82 / $575.44	Facility		$104.71	$169.82	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $104.71	Facility		$100.00	$100.00	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $123.03	Professional		$104.71	$104.71	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $208.93	Professional		$83.18	$104.71	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $104.71 / $194.98	Professional		$30.20	$104.71	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $190.55 / $269.15	Facility		$97.72	$190.55	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $125.89	Professional		$100.00	$104.71	$125.89