Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.34 / $123.34 / $123.34	Facility		$123.34	$123.34	$123.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.50 / $123.34 / $309.98	Professional		$91.50	$123.34	$309.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.49 / $213.94 / $213.94	Professional		$160.49	$213.94	$213.94
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 $62.40 / $67.39 / $103.21	Professional		$62.40	$67.39	$103.21
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.86 / $308.61	Professional		$100.00	$134.86	$308.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.14 / $73.14 / $77.45	Professional		$73.14	$73.14	$77.45
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $420.54 / $420.54 / $420.54	Professional		$420.54	$420.54	$420.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.81 / $140.59 / $277.04	Professional		$118.81	$140.59	$277.04
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $187.00 / $437.21 / $453.15	Facility		$187.00	$437.21	$453.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $535.96 / $535.96 / $823.13	Professional		$535.96	$535.96	$823.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $116.37	Professional		$85.00	$85.00	$116.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $86.91 / $146.69 / $194.29	Facility		$86.91	$146.69	$194.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $73.14 / $73.14 / $112.73	Professional		$73.14	$73.14	$112.73
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $132.30 / $161.69	Professional		$117.60	$132.30	$161.69
United Facility/Professional Professional Modifier Low / Median / High Price $53.54 / $118.91 / $349.09	Professional		$53.54	$118.91	$349.09