Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $4,365.16 / $9,332.54	Facility		$104.71	$4,365.16	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $190.55	Professional		$104.71	$104.71	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $199.53	Professional		$109.65	$109.65	$199.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $169.82 / $575.44	Facility		$104.71	$169.82	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $107.15	Professional		$104.71	$104.71	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $104.71	Facility		$97.72	$97.72	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $134.90	Professional		$104.71	$104.71	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $309.03	Professional		$104.71	$125.89	$309.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $104.71 / $446.68	Professional		$30.20	$104.71	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $295.12 / $416.87	Facility		$151.36	$295.12	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $158.49	Professional		$104.71	$109.65	$158.49