Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $50.00 / $62.50	Professional		$11.00	$50.00	$62.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.08 / $83.08 / $83.08	Facility		$83.08	$83.08	$83.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $79.52 / $103.66	Professional		$34.00	$79.52	$103.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $49.64 / $70.92 / $76.59	Professional		$49.64	$70.92	$76.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $60.00 / $65.00	Facility		$45.00	$60.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.91 / $55.00 / $75.00	Professional		$41.91	$55.00	$75.00
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $97.50 / $97.50	Professional		$97.50	$97.50	$97.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.00 / $90.00	Professional		$50.00	$75.00	$90.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $270.00 / $270.00 / $270.00	Facility		$270.00	$270.00	$270.00
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 $30.00 / $30.00 / $45.00	Facility		$30.00	$30.00	$45.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $60.00 / $75.00	Professional		$45.00	$60.00	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.19 / $76.13	Professional		$50.00	$75.19	$76.13