Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.20 / $5,814.61 / $23,109.30	Facility		$73.20	$5,814.61	$23,109.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $74.31 / $146.10	Professional		$73.05	$74.31	$146.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $73.05 / $76.70	Professional		$72.73	$73.05	$76.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.20 / $117.12 / $268.64	Facility		$73.20	$117.12	$268.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $73.20 / $79.05	Professional		$73.20	$73.20	$79.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.20 / $73.20 / $117.12	Facility		$73.20	$73.20	$117.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $73.20 / $117.12	Professional		$73.05	$73.20	$117.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.06 / $69.06 / $73.20	Facility		$69.06	$69.06	$73.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $73.20 / $93.23	Professional		$73.20	$73.20	$93.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.19 / $80.64 / $167.31	Professional		$73.19	$80.64	$167.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $117.12 / $152.69	Professional		$73.20	$117.12	$152.69
United Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $77.19 / $95.63	Professional		$73.20	$77.19	$95.63