Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $2,227.00 / $9,320.75	Facility		$108.47	$2,227.00	$9,320.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $109.28 / $161.06	Professional		$108.47	$109.28	$161.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $279.25 / $279.25 / $279.25	Professional		$279.25	$279.25	$279.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $173.55 / $398.08	Facility		$108.47	$173.55	$398.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $117.14	Professional		$108.47	$108.47	$117.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $108.47 / $212.60	Facility		$108.47	$108.47	$212.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $108.47	Professional		$108.47	$108.47	$108.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $108.47	Facility		$102.33	$102.33	$108.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $138.13	Professional		$108.47	$108.47	$138.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.05 / $163.26 / $707.90	Professional		$136.05	$163.26	$707.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.04 / $176.81 / $451.20	Professional		$103.04	$176.81	$451.20
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $114.98 / $144.38	Professional		$108.47	$114.98	$144.38