Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Facility		$45.00	$45.00	$45.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $27.85 / $49.61	Professional		$22.37	$27.85	$49.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.93 / $23.60 / $23.60	Professional		$17.93	$23.60	$23.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.47 / $82.23 / $82.23	Facility		$76.47	$82.23	$82.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.19 / $48.65 / $111.45	Professional		$17.19	$48.65	$111.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $91.00 / $127.40	Professional		$42.46	$91.00	$127.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $262.00	Facility		$200.00	$200.00	$262.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $27.00 / $62.49	Professional		$21.00	$27.00	$62.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.65 / $25.51 / $38.39	Professional		$21.65	$25.51	$38.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $105.96 / $114.90 / $1,400.00	Facility		$105.96	$114.90	$1,400.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $158.99 / $203.93	Professional		$150.33	$158.99	$203.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.40 / $50.00 / $85.00	Professional		$24.40	$50.00	$85.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $22.29 / $25.26 / $30.68	Professional		$22.29	$25.26	$30.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.15 / $30.10 / $51.75	Facility		$23.15	$30.10	$51.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $32.17 / $66.38	Professional		$22.00	$32.17	$66.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $22.29 / $25.26 / $30.68	Professional		$22.29	$25.26	$30.68
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $22.90 / $25.77 / $31.49	Professional		$22.90	$25.77	$31.49
United Facility/Professional Facility Modifier Low / Median / High Price $28.71 / $28.71 / $28.71	Facility		$28.71	$28.71	$28.71
United Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $30.17 / $104.45	Professional		$21.28	$30.17	$104.45