Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.53 / $84.57 / $275.48	Facility		$84.53	$84.57	$275.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $84.57 / $102.28	Professional		$84.53	$84.57	$102.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $135.31 / $310.37	Facility		$84.57	$135.31	$310.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $86.26	Professional		$84.57	$84.57	$86.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $84.57 / $165.76	Facility		$84.57	$84.57	$165.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $84.57	Professional		$84.57	$84.57	$84.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.78 / $79.78 / $84.57	Facility		$79.78	$79.78	$84.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $107.71	Professional		$84.57	$84.57	$107.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $152.69 / $496.00	Professional		$117.45	$152.69	$496.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $135.32 / $174.27	Professional		$80.34	$135.32	$174.27
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $103.52	Professional		$84.57	$84.57	$103.52