Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $446.68 / $58,884.37	Facility		$208.93	$446.68	$58,884.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $251.19	Professional		$208.93	$208.93	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $398.11 / $1,148.15	Facility		$208.93	$398.11	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $208.93	Professional		$199.53	$208.93	$208.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $208.93	Facility		$199.53	$199.53	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $245.47	Professional		$208.93	$208.93	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $416.87	Professional		$208.93	$251.19	$416.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $229.09 / $407.38	Professional		$30.20	$229.09	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $398.11 / $562.34	Facility		$204.17	$398.11	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $218.78 / $263.03	Professional		$204.17	$218.78	$263.03