Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Facility		$89.75	$89.75	$89.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $94.23	Professional		$89.75	$89.75	$94.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $91.54	Professional		$89.75	$89.75	$91.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $175.91	Facility		$89.75	$89.75	$175.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $84.67 / $89.75	Facility		$84.67	$84.67	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $114.30	Professional		$89.75	$89.75	$114.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $73.42 / $156.00	Professional		$73.42	$73.42	$156.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $152.57 / $166.03 / $239.19	Professional		$152.57	$166.03	$239.19
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $183.09	Professional		$89.75	$89.75	$183.09