Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $194.98 / $1,288.25	Facility		$120.23	$194.98	$1,288.25
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $89.13 / $100.00	Facility		$61.66	$89.13	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $7,244.36 / $15,135.61	Facility		$1,819.70	$7,244.36	$15,135.61
HealthNet Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,995.26 / $6,025.60	Facility		$724.44	$1,995.26	$6,025.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $194.98 / $316.23	Facility		$117.49	$194.98	$316.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $6,760.83 / $15,135.61	Facility		$1,819.70	$6,760.83	$15,135.61