Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $926.00 / $1,704.00 / $4,164.00	Facility		$926.00	$1,704.00	$4,164.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $183.53 / $746.56	Professional		$151.44	$183.53	$746.56
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $447.20 / $11,487.84 / $24,101.95	Facility		$447.20	$11,487.84	$24,101.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $112.86 / $177.35 / $458.43	Professional		$112.86	$177.35	$458.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $120.22 / $233.95	Professional		$53.05	$120.22	$233.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $382.10 / $946.16 / $1,109.17	Facility		$382.10	$946.16	$1,109.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,172.58 / $1,172.58 / $1,594.65	Professional		$1,172.58	$1,172.58	$1,594.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.66 / $167.11 / $218.65	Facility		$63.66	$167.11	$218.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $53.05 / $200.53	Professional		$53.05	$53.05	$200.53
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.75 / $58.36 / $183.82	Professional		$47.75	$58.36	$183.82
United Facility/Professional Facility Modifier Low / Median / High Price $253.97 / $253.97 / $253.97	Facility		$253.97	$253.97	$253.97
United Facility/Professional Professional Modifier Low / Median / High Price $157.82 / $201.54 / $389.16	Professional		$157.82	$201.54	$389.16