Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $181.97 / $20,892.96	Facility		$173.78	$181.97	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $218.78	Professional		$173.78	$173.78	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $302.00	Professional		$173.78	$173.78	$302.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $323.59 / $954.99	Facility		$173.78	$323.59	$954.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $257.04	Facility		$173.78	$173.78	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $275.42	Professional		$173.78	$181.97	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $173.78	Facility		$162.18	$162.18	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $204.17	Professional		$173.78	$173.78	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $275.42	Professional		$117.49	$173.78	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $173.78 / $295.12	Professional		$154.88	$173.78	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $323.59 / $457.09	Facility		$165.96	$323.59	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $218.78	Professional		$165.96	$173.78	$218.78