Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.59 / $129.00 / $452.04	Facility		$70.59	$129.00	$452.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.92 / $158.47 / $387.25	Professional		$108.92	$158.47	$387.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.40 / $125.00 / $381.60	Professional		$54.40	$125.00	$381.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.65 / $293.00 / $876.00	Facility		$32.65	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.08 / $131.69 / $269.27	Professional		$85.08	$131.69	$269.27
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.60 / $146.79 / $406.74	Professional		$100.60	$146.79	$406.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.08 / $272.08 / $516.32	Facility		$121.08	$272.08	$516.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.89 / $189.47 / $351.12	Professional		$118.89	$189.47	$351.12
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $420.57 / $420.57 / $420.57	Professional		$420.57	$420.57	$420.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $149.00 / $163.00 / $594.00	Professional		$149.00	$163.00	$594.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $255.33 / $668.04 / $668.04	Facility		$255.33	$668.04	$668.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $810.58 / $810.58 / $1,053.68	Professional		$810.58	$810.58	$1,053.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $70.00	Professional		$30.00	$60.00	$70.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $110.24 / $169.23 / $279.64	Facility		$110.24	$169.23	$279.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $124.54 / $193.49 / $364.93	Professional		$124.54	$193.49	$364.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $12.50 / $12.50 / $12.50	Professional		$12.50	$12.50	$12.50
United Facility/Professional Facility Modifier Low / Median / High Price $143.94 / $143.94 / $143.94	Facility		$143.94	$143.94	$143.94
United Facility/Professional Professional Modifier Low / Median / High Price $126.94 / $161.54 / $355.15	Professional		$126.94	$161.54	$355.15