Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.26 / $91.26 / $216.79	Facility		$91.26	$91.26	$216.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $115.28 / $152.66	Professional		$91.26	$115.28	$152.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $192.17 / $269.04 / $705.26	Facility		$192.17	$269.04	$705.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.46 / $159.79 / $306.80	Professional		$102.46	$159.79	$306.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.34 / $173.08 / $355.51	Facility		$163.34	$173.08	$355.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $163.34 / $163.34 / $163.34	Professional		$163.34	$163.34	$163.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.31 / $124.31 / $124.31	Facility		$124.31	$124.31	$124.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.75 / $90.75 / $261.83	Professional		$90.75	$90.75	$261.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.05 / $192.17 / $289.97	Professional		$146.05	$192.17	$289.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $237.59 / $240.21 / $245.03	Professional		$237.59	$240.21	$245.03
United Facility/Professional Professional Modifier Low / Median / High Price $63.92 / $95.87 / $158.16	Professional		$63.92	$95.87	$158.16