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 / $5.01 / $5.01	Professional		$5.01	$5.01	$5.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $354.81 / $891.25	Facility		$281.84	$354.81	$891.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $380.19	Professional		$281.84	$380.19	$380.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $660.69 / $1,122.02	Professional		$467.74	$660.69	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $630.96	Professional		$125.89	$138.04	$630.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $194.98	Facility		$181.97	$181.97	$194.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $251.19	Professional		$194.98	$194.98	$251.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $5.01 / $5.25 / $10.47	Facility		$5.01	$5.25	$10.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90