Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $7,413.10 / $19,054.61	Facility		$3,019.95	$7,413.10	$19,054.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $3,019.95 / $3,630.78	Professional		$2,884.03	$3,019.95	$3,630.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,715.35 / $7,413.10	Facility		$3,235.94	$3,715.35	$7,413.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,090.30 / $6,918.31	Professional		$3,019.95	$3,090.30	$6,918.31
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $100.00 / $4,073.80	Facility		$83.18	$100.00	$4,073.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,890.45 / $8,317.64	Professional		$3,019.95	$3,890.45	$8,317.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility		$3,090.30	$3,090.30	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Professional		$3,090.30	$3,090.30	$3,090.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $14,454.40 / $14,454.40 / $14,454.40	Facility		$14,454.40	$14,454.40	$14,454.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Professional		$2,454.71	$2,454.71	$2,454.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $4,265.80 / $8,317.64	Facility		$2,187.76	$4,265.80	$8,317.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Professional		$3,090.30	$3,090.30	$3,090.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $4,168.69 / $4,168.69	Facility		$2,884.03	$4,168.69	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $6,606.93	Professional		$3,019.95	$3,019.95	$6,606.93