Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $105.33 / $304.14	Facility		$68.20	$105.33	$304.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $86.70	Professional		$68.20	$68.20	$86.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $109.12 / $250.29	Facility		$68.20	$109.12	$250.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $73.65	Professional		$68.20	$68.20	$73.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $68.20 / $133.66	Facility		$68.20	$68.20	$133.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $68.20	Professional		$68.20	$68.20	$68.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $64.34 / $68.20	Facility		$64.34	$64.34	$68.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $113.40	Professional		$68.20	$68.20	$113.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.89 / $172.95 / $376.00	Professional		$47.89	$172.95	$376.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $126.16 / $152.50	Professional		$68.20	$126.16	$152.50
United Facility/Professional Facility Modifier Low / Median / High Price $59.53 / $116.08 / $116.08	Facility		$59.53	$116.08	$116.08
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $69.01 / $90.78	Professional		$68.20	$69.01	$90.78