Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.32 / $52.74 / $194.02	Facility		$46.32	$52.74	$194.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $46.32 / $63.82	Professional		$46.32	$46.32	$63.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $60.26 / $92.30	Professional		$46.32	$60.26	$92.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.32 / $74.11 / $169.99	Facility		$46.32	$74.11	$169.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $46.32 / $47.24	Professional		$46.32	$46.32	$47.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.32 / $46.32 / $90.79	Facility		$46.32	$46.32	$90.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $46.32 / $46.32	Professional		$46.32	$46.32	$46.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.70 / $43.70 / $46.32	Facility		$43.70	$43.70	$46.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $46.32 / $58.99	Professional		$46.32	$46.32	$58.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.70 / $68.51 / $253.00	Professional		$52.70	$68.51	$253.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $67.89 / $95.45	Professional		$39.93	$67.89	$95.45
United Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $49.10 / $59.29	Professional		$46.32	$49.10	$59.29