Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.83 / $20.83 / $250.86	Facility		$20.83	$20.83	$250.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.83 / $20.83 / $29.28	Professional		$20.83	$20.83	$29.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.00 / $269.00 / $376.00	Facility		$121.00	$269.00	$376.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $14.50 / $24.00	Professional		$12.32	$14.50	$24.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $72.00 / $85.00	Facility		$72.00	$72.00	$85.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $638.07 / $801.00	Professional		$393.93	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $100.00 / $557.50	Facility		$65.00	$100.00	$557.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $100.88 / $272.97 / $272.97	Professional		$100.88	$272.97	$272.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.98 / $32.34 / $60.00	Professional		$29.98	$32.34	$60.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.83 / $20.83 / $160.16	Facility		$20.83	$20.83	$160.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,250,000.00 / $2,250,000.00 / $2,400,000.00	Professional		$2,250,000.00	$2,250,000.00	$2,400,000.00