Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.55 / $69.31 / $183.24	Facility		$57.55	$69.31	$183.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $23.80 / $242.10	Professional		$23.80	$23.80	$242.10
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $48.66 / $68.39 / $100.37	Professional		$48.66	$68.39	$100.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.74 / $32.74 / $32.74	Facility		$32.74	$32.74	$32.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $23.90 / $32.74	Professional		$23.90	$23.90	$32.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $54.00 / $393.93	Professional		$46.00	$54.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $100.00	Facility		$90.00	$90.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $78.59 / $78.59	Professional		$78.59	$78.59	$78.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $85.00	Professional		$70.00	$70.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $32.74	Facility		$25.00	$25.00	$32.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $23.90 / $32.74	Professional		$23.90	$23.90	$32.74
United Facility/Professional Professional Modifier Low / Median / High Price $128.79 / $128.79 / $128.79	Professional		$128.79	$128.79	$128.79