Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $38.90	Facility		$21.88	$21.88	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.88 / $33.11	Professional		$21.38	$21.88	$33.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $27.54 / $57.54	Facility		$23.99	$27.54	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $23.44 / $48.98	Professional		$16.22	$23.44	$48.98
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $21.88 / $34.67	Facility		$19.95	$21.88	$34.67
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.70 / $58.88	Professional		$19.50	$25.70	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $24.55 / $47.86	Professional		$19.95	$24.55	$47.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $31.62 / $58.88	Facility		$16.98	$31.62	$58.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $24.55 / $37.15	Professional		$17.78	$24.55	$37.15
United Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Facility		$38.02	$38.02	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $23.99 / $48.98	Professional		$21.88	$23.99	$48.98