Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,765.00 / $2,200.00 / $4,168.00	Facility		$1,765.00	$2,200.00	$4,168.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,765.00 / $2,200.00	Professional		$1,000.00	$1,765.00	$2,200.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.58 / $353.00 / $2,523.00	Facility		$85.58	$353.00	$2,523.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $491.50 / $1,628.41 / $2,535.83	Professional		$491.50	$1,628.41	$2,535.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $447.81 / $2,270.21	Facility		$59.40	$447.81	$2,270.21
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,044.86 / $1,492.67 / $3,572.39	Professional		$1,044.86	$1,492.67	$3,572.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $754.41 / $3,298.93 / $7,748.68	Facility		$754.41	$3,298.93	$7,748.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.26 / $420.13 / $1,307.65	Professional		$239.26	$420.13	$1,307.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $853.30 / $1,054.29 / $1,801.96	Professional		$853.30	$1,054.29	$1,801.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,877.71 / $4,442.64 / $4,442.64	Facility		$3,877.71	$4,442.64	$4,442.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,302.23 / $9,962.67 / $10,235.64	Professional		$5,302.23	$9,962.67	$10,235.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.21 / $1,000.00 / $4,415.57	Facility		$114.21	$1,000.00	$4,415.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.26 / $466.29 / $1,384.60	Professional		$239.26	$466.29	$1,384.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,554.95 / $1,554.95 / $1,554.95	Facility		$1,554.95	$1,554.95	$1,554.95
United Facility/Professional Professional Modifier Low / Median / High Price $953.87 / $1,646.28 / $4,397.31	Professional		$953.87	$1,646.28	$4,397.31