Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.91 / $43.91 / $104.30	Facility		$43.91	$43.91	$104.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $55.46 / $109.10	Professional		$42.90	$55.46	$109.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.46 / $129.44 / $339.33	Facility		$92.46	$129.44	$339.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.10 / $76.88 / $150.00	Professional		$49.10	$76.88	$150.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.29 / $78.59 / $171.05	Facility		$76.29	$78.59	$171.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $78.59 / $78.59	Professional		$78.59	$78.59	$78.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Facility		$61.54	$61.54	$61.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $61.54 / $109.77	Professional		$44.92	$61.54	$109.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.27 / $92.46 / $239.93	Professional		$70.27	$92.46	$239.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $157.18 / $160.33 / $174.47	Professional		$157.18	$160.33	$174.47
United Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $46.13 / $76.88	Professional		$30.75	$46.13	$76.88