Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $95.00 / $125.00	Professional		$21.00	$95.00	$125.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.64 / $165.64 / $165.64	Facility		$165.64	$165.64	$165.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.50 / $139.00 / $206.70	Professional		$93.50	$139.00	$206.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $99.29 / $141.84 / $153.19	Professional		$99.29	$141.84	$153.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $120.00 / $137.91	Facility		$90.00	$120.00	$137.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $120.00 / $148.31	Professional		$90.00	$120.00	$148.31
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $100.00 / $195.00	Professional		$75.00	$100.00	$195.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $150.00 / $180.00	Professional		$100.00	$150.00	$180.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $260.00 / $260.00	Facility		$260.00	$260.00	$260.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.00 / $60.00	Professional		$32.34	$60.00	$60.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $90.00	Facility		$60.00	$60.00	$90.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $120.00 / $150.00	Professional		$90.00	$120.00	$150.00
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $142.29 / $165.00	Professional		$100.00	$142.29	$165.00