Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,173.82 / $5,087.97 / $11,316.46	Facility		$2,173.82	$5,087.97	$11,316.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,229.76 / $5,087.97 / $5,087.97	Professional		$4,229.76	$5,087.97	$5,087.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,697.25 / $5,031.62 / $7,733.65	Facility		$2,697.25	$5,031.62	$7,733.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,655.39 / $5,210.58 / $10,004.31	Professional		$3,655.39	$5,210.58	$10,004.31
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $79.00 / $91.00	Facility		$77.09	$79.00	$91.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $924.00 / $1,320.00 / $3,217.76	Professional		$924.00	$1,320.00	$3,217.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $5,210.58	Facility		$5,210.58	$5,210.58	$5,210.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $5,210.58	Professional		$5,210.58	$5,210.58	$5,210.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $393.93	Professional		$100.00	$100.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,823.59 / $12,260.18 / $21,893.18	Facility		$5,823.59	$12,260.18	$21,893.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $22,185.08 / $23,294.34 / $26,271.81	Professional		$22,185.08	$23,294.34	$26,271.81
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 $4,904.07 / $6,130.09 / $7,570.67	Facility		$4,904.07	$6,130.09	$7,570.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $5,210.58 / $5,210.58 / $6,130.09	Professional		$5,210.58	$5,210.58	$6,130.09
United Facility/Professional Professional Modifier Low / Median / High Price $5,108.41 / $5,108.41 / $9,813.26	Professional		$5,108.41	$5,108.41	$9,813.26