Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $10,004.00 / $22,788.00	Facility		$1,875.00	$10,004.00	$22,788.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $2,125.00	Professional		$1,875.00	$1,875.00	$2,125.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $9,590.00 / $20,146.00	Facility		$1,900.00	$9,590.00	$20,146.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,456.19 / $1,823.77 / $3,276.29	Professional		$1,456.19	$1,823.77	$3,276.29
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 $936.60 / $1,338.00 / $2,943.60	Professional		$936.60	$1,338.00	$2,943.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $766.00 / $5,662.00	Facility		$629.00	$766.00	$5,662.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $525.00 / $1,148.42	Professional		$350.00	$525.00	$1,148.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $18,000.00 / $18,000.00	Professional		$393.93	$18,000.00	$18,000.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $4,714.20	Facility		$55.00	$55.00	$4,714.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,588.36 / $6,588.36 / $6,805.78	Professional		$6,588.36	$6,588.36	$6,805.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $70.00 / $85.00	Professional		$60.00	$70.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $3,967.43	Facility		$1,875.00	$1,875.00	$3,967.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $511.00 / $950.60	Professional		$350.00	$511.00	$950.60
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
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $7,980.00	Professional		$45.00	$45.00	$7,980.00