Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $274.83 / $327.23 / $553.65	Facility		$274.83	$327.23	$553.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $376.00 / $376.00	Professional		$71.00	$376.00	$376.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $488.15 / $684.32 / $1,118.53	Professional		$488.15	$684.32	$1,118.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $31.24 / $31.24	Professional		$31.24	$31.24	$31.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.00 / $393.93 / $801.00	Professional		$127.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $197.12	Facility		$100.00	$100.00	$197.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $197.12 / $253.44 / $253.44	Professional		$197.12	$253.44	$253.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $85.00 / $85.00	Professional		$70.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $11.20	Facility		$5.00	$5.00	$11.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $31.24 / $31.24	Professional		$31.24	$31.24	$31.24