Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Facility		$97.94	$97.94	$97.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $105.85	Professional		$97.94	$97.94	$105.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $359.44	Facility		$97.94	$97.94	$359.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $99.89	Professional		$97.94	$97.94	$99.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $191.96	Facility		$97.94	$97.94	$191.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $92.40 / $97.94	Facility		$92.40	$92.40	$97.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $124.73	Professional		$97.94	$97.94	$124.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.79 / $102.79 / $338.00	Professional		$102.79	$102.79	$338.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $166.50 / $181.19 / $239.19	Professional		$166.50	$181.19	$239.19
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $153.26	Professional		$97.94	$97.94	$153.26