Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $1,750.27	Facility		$300.00	$300.00	$1,750.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.74 / $300.00 / $2,739.87	Professional		$299.74	$300.00	$2,739.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $624.00 / $656.00	Professional		$140.00	$624.00	$656.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.58 / $293.00 / $876.00	Facility		$97.58	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.48 / $115.93 / $1,034.69	Professional		$81.48	$115.93	$1,034.69
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $79.00 / $91.00	Facility		$77.09	$79.00	$91.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $75.00 / $167.12	Professional		$52.50	$75.00	$167.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.55 / $1,199.26 / $1,518.64	Professional		$876.55	$1,199.26	$1,518.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $432.00 / $801.00 / $2,123.00	Professional		$432.00	$801.00	$2,123.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $299.74 / $300.00 / $454.77	Facility		$299.74	$300.00	$454.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.83 / $137.83 / $137.83	Professional		$137.83	$137.83	$137.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $40.29 / $45.66	Professional		$26.86	$40.29	$45.66