Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.10 / $20.10 / $20.10	Facility		$20.10	$20.10	$20.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.10 / $155.33 / $225.65	Professional		$20.10	$155.33	$225.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.94 / $31.37 / $82.61	Facility		$25.94	$31.37	$82.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $35.45 / $72.47	Professional		$27.04	$35.45	$72.47
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $129.15 / $184.50 / $409.59	Professional		$129.15	$184.50	$409.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $261.13 / $261.13 / $261.13	Facility		$261.13	$261.13	$261.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.29 / $182.29 / $182.29	Professional		$182.29	$182.29	$182.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $244.94 / $299.38 / $476.28	Professional		$244.94	$299.38	$476.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $451.11 / $1,216.29 / $1,216.29	Facility		$451.11	$1,216.29	$1,216.29
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,215.19 / $1,215.19 / $1,985.78	Professional		$1,215.19	$1,215.19	$1,985.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $70.00 / $244.72	Professional		$60.00	$70.00	$244.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.82 / $201.05 / $367.28	Facility		$23.82	$201.05	$367.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $182.29 / $182.29 / $343.55	Professional		$182.29	$182.29	$343.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $217.73 / $272.16 / $299.38	Professional		$217.73	$272.16	$299.38
United Facility/Professional Professional Modifier Low / Median / High Price $139.05 / $217.35 / $500.80	Professional		$139.05	$217.35	$500.80