Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $62.97 / $205.47	Facility		$61.44	$62.97	$205.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $62.05 / $76.19	Professional		$61.44	$62.05	$76.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.07 / $114.07 / $114.07	Professional		$114.07	$114.07	$114.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $98.30 / $225.48	Facility		$61.44	$98.30	$225.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $62.66	Professional		$61.44	$61.44	$62.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.44 / $61.44 / $120.42	Facility		$61.44	$61.44	$120.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $61.44	Professional		$61.44	$61.44	$61.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.96 / $57.96 / $61.44	Facility		$57.96	$57.96	$61.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $61.44 / $78.23	Professional		$61.44	$61.44	$78.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $79.48 / $182.00	Professional		$63.06	$79.48	$182.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $103.82 / $160.90	Professional		$58.36	$103.82	$160.90
United Facility/Professional Professional Modifier Low / Median / High Price $61.44 / $65.13 / $83.79	Professional		$61.44	$65.13	$83.79