Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $125.38 / $16,756.74	Facility		$100.09	$125.38	$16,756.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.30 / $120.36	Professional		$100.09	$100.30	$120.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $160.13 / $367.33	Facility		$100.09	$160.13	$367.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $102.09	Professional		$100.09	$100.09	$102.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $100.09 / $196.18	Facility		$100.09	$100.09	$196.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $100.09	Professional		$100.09	$100.09	$100.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.42 / $94.42 / $100.09	Facility		$94.42	$94.42	$100.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $125.64	Professional		$100.09	$100.09	$125.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.12 / $106.65 / $212.00	Professional		$84.12	$106.65	$212.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.08 / $170.15 / $206.18	Professional		$95.08	$170.15	$206.18
United Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $102.09 / $125.64	Professional		$100.09	$102.09	$125.64