Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $217.09 / $25,401.75	Facility		$217.09	$217.09	$25,401.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $249.65	Professional		$217.09	$217.09	$249.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $347.34 / $796.72	Facility		$217.09	$347.34	$796.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $221.43	Professional		$217.09	$217.09	$221.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $217.09 / $217.09 / $425.50	Facility		$217.09	$217.09	$425.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $217.09	Professional		$217.09	$217.09	$217.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.80 / $204.80 / $217.09	Facility		$204.80	$204.80	$217.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $217.09 / $251.88	Professional		$217.09	$217.09	$251.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $214.76 / $279.19 / $765.00	Professional		$214.76	$279.19	$765.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $206.23 / $347.34 / $447.35	Professional		$206.23	$347.34	$447.35
United Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $230.12 / $271.36	Professional		$217.09	$230.12	$271.36