Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $851.14 / $1,047.13	Professional		$489.78	$851.14	$1,047.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $120.23	Professional		$95.50	$95.50	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $112.20 / $288.40	Facility		$89.13	$112.20	$288.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,047.13 / $3,162.28	Professional		$707.95	$1,047.13	$3,162.28
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $190.55 / $457.09	Facility		$91.20	$190.55	$457.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $851.14 / $1,412.54	Professional		$537.03	$851.14	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $831.76 / $1,698.24	Professional		$128.82	$831.76	$1,698.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $5,011.87 / $5,011.87	Facility		$4,786.30	$5,011.87	$5,011.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $7,762.47 / $7,762.47	Professional		$4,677.35	$7,762.47	$7,762.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $851.14 / $1,698.24	Facility		$95.50	$851.14	$1,698.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $776.25 / $776.25	Professional		$97.72	$776.25	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $87.10 / $1,288.25	Facility		$51.29	$87.10	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $107.15 / $724.44	Professional		$51.29	$107.15	$724.44