Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $626.86 / $691.89 / $691.89	Facility		$626.86	$691.89	$691.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.94 / $632.95 / $748.71	Professional		$562.94	$632.95	$748.71
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 $426.25 / $642.97 / $2,894.99	Professional		$426.25	$642.97	$2,894.99
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $19,950.95	Facility		$66.09	$100.00	$19,950.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $405.07 / $578.66 / $1,324.23	Professional		$405.07	$578.66	$1,324.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,467.19 / $1,940.34 / $3,484.72	Facility		$1,467.19	$1,940.34	$3,484.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $480.97 / $525.50 / $710.11	Professional		$480.97	$525.50	$710.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $191.20 / $420.66 / $839.68	Professional		$191.20	$420.66	$839.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,464.88 / $4,354.92 / $4,532.39	Facility		$3,464.88	$4,354.92	$4,532.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,140.28 / $4,140.28 / $5,314.43	Professional		$4,140.28	$4,140.28	$5,314.43
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 $229.44 / $719.72 / $1,594.55	Facility		$229.44	$719.72	$1,594.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $191.20 / $506.26 / $719.72	Professional		$191.20	$506.26	$719.72
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $172.09 / $210.33 / $659.75	Professional		$172.09	$210.33	$659.75
United Facility/Professional Facility Modifier Low / Median / High Price $745.31 / $745.31 / $745.31	Facility		$745.31	$745.31	$745.31
United Facility/Professional Professional Modifier Low / Median / High Price $423.17 / $820.59 / $1,646.77	Professional		$423.17	$820.59	$1,646.77