Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $101.03 / $101.03	Facility		$101.03	$101.03	$101.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $123.70	Professional		$101.03	$101.03	$123.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $101.03 / $370.78	Facility		$101.03	$101.03	$370.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $103.05	Professional		$101.03	$101.03	$103.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $101.03 / $198.02	Facility		$101.03	$101.03	$198.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.31 / $95.31 / $101.03	Facility		$95.31	$95.31	$101.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $128.66	Professional		$101.03	$101.03	$128.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.69 / $105.69 / $211.00	Professional		$105.69	$105.69	$211.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $171.75 / $186.91 / $239.19	Professional		$171.75	$186.91	$239.19
United Facility/Professional Facility Modifier Low / Median / High Price $290.02 / $290.02 / $290.02	Facility		$290.02	$290.02	$290.02
United Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $175.93	Professional		$101.03	$101.03	$175.93