Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $19.95 / $19.95	Facility		$17.38	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $138.04	Professional		$19.95	$19.95	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $56.23 / $141.25	Facility		$44.67	$56.23	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $57.54 / $60.26	Professional		$56.23	$57.54	$60.26
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $91.20 / $138.04	Professional		$52.48	$91.20	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $630.96	Professional		$58.88	$79.43	$630.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $33.88	Facility		$19.95	$19.95	$33.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $31.62	Professional		$30.20	$30.20	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $51.29 / $51.29	Professional		$12.02	$51.29	$51.29