Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $926.00 / $1,704.00 / $4,164.00	Facility		$926.00	$1,704.00	$4,164.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.50 / $233.50 / $1,635.35	Professional		$233.50	$233.50	$1,635.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $97.51	Professional		$40.00	$40.00	$97.51
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 / $100.00	Facility		$100.00	$100.00	$100.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $37.79 / $67.20	Facility		$30.00	$37.79	$67.20