Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,135.99 / $10,004.00 / $22,788.00	Facility		$3,135.99	$10,004.00	$22,788.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,135.99 / $3,135.99 / $3,135.99	Professional		$3,135.99	$3,135.99	$3,135.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,883.00 / $9,005.00 / $19,398.00	Facility		$2,883.00	$9,005.00	$19,398.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,217.46 / $2,793.75 / $274,999.96	Professional		$2,217.46	$2,793.75	$274,999.96
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $5,487.90	Facility		$63.90	$100.00	$5,487.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.77 / $638.07 / $801.00	Professional		$257.77	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $32,630.00	Facility		$55.00	$55.00	$32,630.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $42,198.16 / $42,198.16 / $43,590.69	Professional		$42,198.16	$42,198.16	$43,590.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $85.00 / $821.88	Professional		$60.00	$85.00	$821.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,665.59 / $3,135.99 / $4,484.47	Facility		$2,665.59	$3,135.99	$4,484.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.00 / $4,820.00 / $20,279.00	Facility		$1,055.00	$4,820.00	$20,279.00