Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.01 / $63.01 / $149.66	Facility		$63.01	$63.01	$149.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $81.70 / $105.40	Professional		$63.01	$81.70	$105.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.18 / $98.18 / $98.18	Professional		$98.18	$98.18	$98.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.68 / $185.75 / $486.94	Facility		$132.68	$185.75	$486.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $110.32 / $211.81	Professional		$70.73	$110.32	$211.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.78 / $137.66 / $260.05	Facility		$112.78	$137.66	$260.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.78 / $112.78 / $112.78	Professional		$112.78	$112.78	$112.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $106.22 / $106.22	Facility		$106.22	$106.22	$106.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $102.52 / $177.42	Professional		$77.54	$102.52	$177.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.84 / $132.68 / $199.90	Professional		$100.84	$132.68	$199.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $164.04 / $165.85 / $169.16	Professional		$164.04	$165.85	$169.16
United Facility/Professional Facility Modifier Low / Median / High Price $40.79 / $64.81 / $75.06	Facility		$40.79	$64.81	$75.06
United Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $66.19 / $109.19	Professional		$44.13	$66.19	$109.19