Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $93.18 / $33,246.72	Facility		$62.10	$93.18	$33,246.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.72 / $85.58	Professional		$62.10	$62.72	$85.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.69 / $117.69 / $117.69	Professional		$117.69	$117.69	$117.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $101.10 / $227.91	Facility		$62.10	$101.10	$227.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $67.06	Professional		$62.10	$62.10	$67.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $121.72	Facility		$62.10	$62.10	$121.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $62.10	Professional		$62.10	$62.10	$62.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $58.58 / $62.10	Facility		$58.58	$58.58	$62.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $79.09	Professional		$62.10	$62.10	$79.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $83.04 / $182.00	Professional		$63.88	$83.04	$182.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.99 / $103.63 / $161.19	Professional		$58.99	$103.63	$161.19
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $65.48 / $82.66	Professional		$62.10	$65.48	$82.66