Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.55 / $73.94 / $127.97	Facility		$73.55	$73.94	$127.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.55 / $73.94 / $88.72	Professional		$73.55	$73.94	$88.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.93 / $118.29 / $271.32	Facility		$73.93	$118.29	$271.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $75.41	Professional		$73.94	$73.94	$75.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.94 / $73.94 / $144.91	Facility		$73.94	$73.94	$144.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $73.94	Professional		$73.94	$73.94	$73.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.75 / $69.75 / $73.94	Facility		$69.75	$69.75	$73.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $73.94 / $87.19	Professional		$73.94	$73.94	$87.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $77.41 / $165.00	Professional		$51.44	$77.41	$165.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $125.69 / $152.37	Professional		$70.23	$125.69	$152.37
United Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $78.38 / $92.43	Professional		$73.94	$78.38	$92.43