Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.20 / $200.20 / $200.20	Professional		$200.20	$200.20	$200.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.96 / $57.76 / $152.69	Facility		$47.96	$57.76	$152.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,500.00 / $2,500.00 / $2,500.00	Professional		$2,500.00	$2,500.00	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,559.00 / $2,559.00 / $2,559.00	Professional		$2,559.00	$2,559.00	$2,559.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $638.07 / $801.00	Professional		$393.93	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $1,161.14	Facility		$100.00	$100.00	$1,161.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,161.14 / $1,161.14 / $1,161.14	Professional		$1,161.14	$1,161.14	$1,161.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,400,000.00 / $2,400,000.00 / $2,400,000.00	Facility		$2,400,000.00	$2,400,000.00	$2,400,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,559.00 / $2,559.00 / $2,559.00	Professional		$2,559.00	$2,559.00	$2,559.00