Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,854.52 / $3,854.52 / $32,378.00	Facility		$3,854.52	$3,854.52	$32,378.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,204.36 / $3,854.52 / $3,854.52	Professional		$3,204.36	$3,854.52	$3,854.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,488.98 / $4,105.68 / $6,879.77	Facility		$2,488.98	$4,105.68	$6,879.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $4,179.60 / $7,616.16	Professional		$3,870.00	$4,179.60	$7,616.16
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $2,264.71 / $3,235.32 / $7,886.74	Professional		$2,264.71	$3,235.32	$7,886.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Facility		$3,947.40	$3,947.40	$3,947.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Professional		$3,947.40	$3,947.40	$3,947.40
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 $8,615.74 / $35,376.98 / $35,376.98	Facility		$8,615.74	$35,376.98	$35,376.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $38,920.43 / $38,920.43 / $38,920.43	Professional		$38,920.43	$38,920.43	$38,920.43
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 $3,947.40 / $4,644.00 / $5,981.12	Facility		$3,947.40	$4,644.00	$5,981.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $4,644.00	Professional		$3,947.40	$3,947.40	$4,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $3,870.00 / $7,496.96	Professional		$3,870.00	$3,870.00	$7,496.96