Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $90.00	Facility		$90.00	$90.00	$90.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $90.00	Professional		$90.00	$90.00	$90.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.64 / $130.55 / $220.87	Facility		$109.64	$130.55	$220.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.20 / $150.00 / $150.00	Professional		$19.20	$150.00	$150.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $104.60 / $146.63 / $239.69	Professional		$104.60	$146.63	$239.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $90.80 / $90.80	Professional		$90.80	$90.80	$90.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $194.00 / $801.00	Professional		$132.00	$194.00	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $254.05	Facility		$100.00	$100.00	$254.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $136.40 / $143.65 / $143.65	Professional		$136.40	$143.65	$143.65
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 $90.00 / $90.00 / $201.60	Facility		$90.00	$90.00	$201.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $90.80 / $90.80	Professional		$90.80	$90.80	$90.80