Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,980.00 / $4,980.00 / $41,832.00	Facility		$4,980.00	$4,980.00	$41,832.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,800.00 / $4,980.00 / $4,980.00	Professional		$4,800.00	$4,980.00	$4,980.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,681.82 / $5,002.84 / $7,689.40	Facility		$2,681.82	$5,002.84	$7,689.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,400.00 / $9,960.00	Professional		$5,100.00	$5,400.00	$9,960.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,681.82 / $5,100.00 / $5,100.00	Facility		$2,681.82	$5,100.00	$5,100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Professional		$5,100.00	$5,100.00	$5,100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,700.00 / $28,500.00 / $28,500.00	Facility		$5,700.00	$28,500.00	$28,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $22,800.00 / $22,800.00 / $27,000.00	Professional		$22,800.00	$22,800.00	$27,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $6,000.00 / $7,410.00	Facility		$5,100.00	$6,000.00	$7,410.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $6,840.00	Professional		$5,100.00	$5,100.00	$6,840.00
United Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $10,038.50	Professional		$5,000.00	$5,000.00	$10,038.50