Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.25 / $241.64 / $886.98	Facility		$97.25	$241.64	$886.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.13 / $120.82 / $162.69	Professional		$92.13	$120.82	$162.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.54 / $151.54 / $151.54	Professional		$151.54	$151.54	$151.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.78 / $286.69 / $751.54	Facility		$204.78	$286.69	$751.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.76 / $170.27 / $326.92	Professional		$111.76	$170.27	$326.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $174.06 / $195.50 / $378.84	Facility		$174.06	$195.50	$378.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $174.06 / $174.06 / $174.06	Professional		$174.06	$174.06	$174.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.51 / $116.51 / $116.51	Facility		$116.51	$116.51	$116.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $85.05 / $249.11	Professional		$85.05	$85.05	$249.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.63 / $204.78 / $333.00	Professional		$155.63	$204.78	$333.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $253.17 / $255.97 / $261.10	Professional		$253.17	$255.97	$261.10
United Facility/Professional Facility Modifier Low / Median / High Price $57.34 / $92.18 / $103.26	Facility		$57.34	$92.18	$103.26
United Facility/Professional Professional Modifier Low / Median / High Price $68.11 / $102.16 / $168.56	Professional		$68.11	$102.16	$168.56