Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,407.05	Facility		$1,393.12	$1,393.12	$1,407.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,532.43	Professional		$1,393.12	$1,393.12	$1,532.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,669.67 / $1,987.97 / $3,363.49	Facility		$1,669.67	$1,987.97	$3,363.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,810.16 / $4,828.42	Professional		$1,393.12	$1,810.16	$4,828.42
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $100.00 / $1,445.35	Facility		$87.40	$100.00	$1,445.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $1,114.50	Professional		$100.00	$100.00	$1,114.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,314.26 / $1,314.26 / $1,393.12	Facility		$1,314.26	$1,314.26	$1,393.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $1,708.54	Professional		$1,393.12	$1,393.12	$1,708.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,253.81 / $1,741.40 / $3,037.00	Professional		$1,253.81	$1,741.40	$3,037.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,340.00 / $4,551.72 / $8,775.00	Facility		$2,340.00	$4,551.72	$8,775.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,190.00 / $8,775.00 / $8,892.00	Professional		$8,190.00	$8,775.00	$8,892.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $85.00 / $85.00	Professional		$70.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,393.12 / $1,532.43 / $2,399.03	Facility		$1,393.12	$1,532.43	$2,399.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $2,437.50	Professional		$1,393.12	$1,393.12	$2,437.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,114.50 / $1,532.43 / $1,532.43	Professional		$1,114.50	$1,532.43	$1,532.43
United Facility/Professional Professional Modifier Low / Median / High Price $1,393.12 / $1,393.12 / $2,676.18	Professional		$1,393.12	$1,393.12	$2,676.18