Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $374.00 / $516.00	Facility		$240.00	$374.00	$516.00
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $167.73 / $348.38 / $348.38	Facility		$167.73	$348.38	$348.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $198.00 / $422.00 / $1,172.00	Facility		$198.00	$422.00	$1,172.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $62.90 / $100.00 / $482.00	Facility		$62.90	$100.00	$482.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $192.00 / $453.00	Facility		$80.00	$192.00	$453.00
HealthNet Facility/Professional Facility Modifier Low / Median / High Price $475.92 / $475.92 / $2,815.62	Facility		$475.92	$475.92	$2,815.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.75 / $118.50 / $300.00	Facility		$23.75	$118.50	$300.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $110.00 / $110.00	Facility		$110.00	$110.00	$110.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $192.00 / $453.00	Facility		$75.00	$192.00	$453.00