Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $355.61 / $1,114.58 / $3,422.03	Facility		$355.61	$1,114.58	$3,422.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.73 / $355.61 / $1,040.46	Professional		$288.73	$355.61	$1,040.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $390.18 / $1,275.83 / $1,275.83	Professional		$390.18	$1,275.83	$1,275.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $497.20 / $530.45 / $601.00	Facility		$497.20	$530.45	$601.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.70 / $500.00 / $1,032.01	Professional		$65.70	$500.00	$1,032.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $210.25 / $300.36 / $732.19	Professional		$210.25	$300.36	$732.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.51 / $440.51 / $440.51	Facility		$440.51	$440.51	$440.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $440.51 / $440.51 / $440.51	Professional		$440.51	$440.51	$440.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $523.00 / $895.00	Professional		$511.00	$523.00	$895.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $958.10 / $2,474.44 / $2,564.67	Facility		$958.10	$2,474.44	$2,564.67
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,033.62 / $3,033.62 / $4,217.63	Professional		$3,033.62	$3,033.62	$4,217.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $564.98	Professional		$85.00	$85.00	$564.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $345.82 / $508.52 / $676.98	Facility		$345.82	$508.52	$676.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $440.51 / $440.51 / $440.51	Professional		$440.51	$440.51	$440.51
United Facility/Professional Professional Modifier Low / Median / High Price $520.75 / $520.75 / $1,055.25	Professional		$520.75	$520.75	$1,055.25