Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $82.86 / $170.68	Facility		$81.90	$82.86	$170.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $100.26	Professional		$81.90	$81.90	$100.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $131.04 / $300.57	Facility		$81.90	$131.04	$300.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $83.53	Professional		$81.90	$81.90	$83.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $81.90 / $160.52	Facility		$81.90	$81.90	$160.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $81.90	Professional		$81.90	$81.90	$81.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $77.26 / $81.90	Facility		$77.26	$77.26	$81.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $104.31	Professional		$81.90	$81.90	$104.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $103.16 / $222.00	Professional		$79.34	$103.16	$222.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $139.22 / $168.71	Professional		$77.81	$139.22	$168.71
United Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $86.81 / $104.39	Professional		$81.90	$86.81	$104.39