Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Facility		$40.00	$40.00	$40.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.35 / $189.73 / $321.00	Facility		$159.35	$189.73	$321.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $218.00 / $218.00	Professional		$58.00	$218.00	$218.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $139.47 / $195.52 / $319.58	Professional		$139.47	$195.52	$319.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $139.72 / $139.72	Professional		$139.72	$139.72	$139.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $261.00 / $801.00	Professional		$132.00	$261.00	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $100.00 / $381.85	Facility		$80.00	$100.00	$381.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $86.22 / $110.85 / $110.85	Professional		$86.22	$110.85	$110.85
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 $40.00 / $40.00 / $89.60	Facility		$40.00	$40.00	$89.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $139.72 / $139.72	Professional		$139.72	$139.72	$139.72