Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,765.00 / $2,200.00 / $4,201.00	Facility		$1,765.00	$2,200.00	$4,201.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,765.00 / $2,200.00	Professional		$1,000.00	$1,765.00	$2,200.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.00 / $876.00 / $2,907.19	Facility		$244.00	$876.00	$2,907.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $938.20 / $2,810.25 / $4,877.72	Professional		$938.20	$2,810.25	$4,877.72
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $89.97 / $104.80 / $214.27	Professional		$89.97	$104.80	$214.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,162.00 / $6,162.00 / $6,162.00	Facility		$6,162.00	$6,162.00	$6,162.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,099.51 / $1,099.51 / $1,382.55	Professional		$1,099.51	$1,099.51	$1,382.55
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 $100.00 / $100.00 / $4,000.00	Facility		$100.00	$100.00	$4,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,908.04 / $5,908.04 / $6,069.92	Professional		$5,908.04	$5,908.04	$6,069.92
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 $950.00 / $1,500.00 / $3,440.00	Facility		$950.00	$1,500.00	$3,440.00
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
United Facility/Professional Professional Modifier Low / Median / High Price $95.71 / $95.71 / $95.71	Professional		$95.71	$95.71	$95.71