Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.72 / $99.72 / $236.87	Facility		$99.72	$99.72	$236.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.72 / $125.96 / $166.81	Professional		$99.72	$125.96	$166.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $209.97 / $293.95 / $770.59	Facility		$209.97	$293.95	$770.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $174.59 / $335.21	Professional		$111.95	$174.59	$335.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $178.47 / $209.97 / $411.54	Facility		$178.47	$209.97	$411.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $178.47 / $178.47 / $178.47	Professional		$178.47	$178.47	$178.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $139.66 / $139.66	Facility		$139.66	$139.66	$139.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $136.65 / $250.13	Professional		$101.95	$136.65	$250.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.58 / $209.97 / $317.43	Professional		$159.58	$209.97	$317.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $259.58 / $262.45 / $267.70	Professional		$259.58	$262.45	$267.70
United Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $104.75 / $174.59	Professional		$69.84	$104.75	$174.59