Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,187.20 / $3,187.20 / $26,772.50	Facility		$3,187.20	$3,187.20	$26,772.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,072.00 / $3,187.20 / $3,264.00	Professional		$3,072.00	$3,187.20	$3,264.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,426.55 / $3,587.14 / $6,683.48	Facility		$2,426.55	$3,587.14	$6,683.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,200.00 / $3,300.00 / $6,266.88	Professional		$3,200.00	$3,300.00	$6,266.88
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $98.60 / $3,504.00	Facility		$76.20	$98.60	$3,504.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $3,187.20 / $3,187.20 / $6,978.69	Professional		$3,187.20	$3,187.20	$6,978.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,264.00	Facility		$3,264.00	$3,264.00	$3,264.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,264.00	Professional		$3,264.00	$3,264.00	$3,264.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $3,648.00 / $4,158.00	Professional		$393.93	$3,648.00	$4,158.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,146.24 / $17,490.00 / $17,490.00	Facility		$9,146.24	$17,490.00	$17,490.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $14,592.00 / $15,048.00 / $17,280.00	Professional		$14,592.00	$15,048.00	$17,280.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,187.20 / $3,840.00 / $4,742.39	Facility		$3,187.20	$3,840.00	$4,742.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $4,950.00	Professional		$3,264.00	$3,264.00	$4,950.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,200.00 / $3,200.00 / $5,856.00	Professional		$3,200.00	$3,200.00	$5,856.00