Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $283.44 / $72,861.78	Facility		$136.22	$283.44	$72,861.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $136.66 / $164.84	Professional		$136.22	$136.66	$164.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $222.50 / $501.58	Facility		$136.66	$222.50	$501.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $139.40	Professional		$136.66	$136.66	$139.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $136.66 / $267.87	Facility		$136.66	$136.66	$267.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $136.66	Professional		$136.66	$136.66	$136.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.93 / $128.93 / $136.66	Facility		$128.93	$128.93	$136.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $161.16	Professional		$136.66	$136.66	$161.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.38 / $159.50 / $301.00	Professional		$113.38	$159.50	$301.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $129.83 / $232.33 / $281.52	Professional		$129.83	$232.33	$281.52
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $144.87 / $174.94	Professional		$136.66	$144.87	$174.94