Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $18,914.87	Facility		$106.33	$136.04	$18,914.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $107.40 / $194.58	Professional		$106.33	$107.40	$194.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.60 / $252.57 / $252.57	Professional		$163.60	$252.57	$252.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $173.11 / $390.23	Facility		$106.33	$173.11	$390.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $114.83	Professional		$106.33	$106.33	$114.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $106.33 / $204.06	Facility		$106.33	$106.33	$204.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $111.65 / $170.13	Professional		$106.33	$111.65	$170.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $100.32 / $106.33	Facility		$100.32	$100.32	$106.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $135.55	Professional		$106.33	$106.33	$135.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.55 / $135.55 / $552.00	Professional		$135.55	$135.55	$552.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.95 / $171.71 / $299.68	Professional		$99.95	$171.71	$299.68
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $112.71 / $136.10	Professional		$106.33	$112.71	$136.10