Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.01 / $5.01 / $5.01	Facility		$5.01	$5.01	$5.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $7.94 / $12.02	Professional		$5.01	$7.94	$12.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $69.18 / $173.78	Facility		$54.95	$69.18	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $9.12 / $16.22	Professional		$5.01	$9.12	$16.22
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $63.10	Professional		$26.30	$37.15	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $10.00	Professional		$10.00	$10.00	$10.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $30.20 / $144.54	Professional		$26.92	$30.20	$144.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $102.33 / $102.33	Professional		$100.00	$102.33	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $15.85 / $15.85	Professional		$15.85	$15.85	$15.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $16.60 / $25.70	Facility		$8.13	$16.60	$25.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $10.23 / $10.23	Professional		$10.23	$10.23	$10.23
United Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $7.76 / $15.14	Professional		$5.25	$7.76	$15.14