Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.20 / $125.20 / $125.20	Facility		$125.20	$125.20	$125.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.04 / $84.95 / $125.20	Professional		$60.04	$84.95	$125.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $27.00 / $40.50	Professional		$27.00	$27.00	$40.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.81 / $184.28 / $207.95	Facility		$158.81	$184.28	$207.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $177.30 / $319.54	Professional		$90.00	$177.30	$319.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $202.00 / $525.66	Professional		$36.00	$202.00	$525.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $225.00 / $638.07	Professional		$160.00	$225.00	$638.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $451.00 / $451.00 / $451.00	Facility		$451.00	$451.00	$451.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $451.00 / $451.00 / $451.00	Professional		$451.00	$451.00	$451.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $85.00 / $174.82	Professional		$70.00	$85.00	$174.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.19 / $100.54 / $162.76	Facility		$84.19	$100.54	$162.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $118.66 / $250.00	Professional		$36.00	$118.66	$250.00
United Facility/Professional Facility Modifier Low / Median / High Price $233.00 / $233.00 / $233.00	Facility		$233.00	$233.00	$233.00
United Facility/Professional Professional Modifier Low / Median / High Price $320.00 / $320.00 / $320.00	Professional		$320.00	$320.00	$320.00