Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $289.00 / $289.00	Facility		$260.00	$289.00	$289.00
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $398.05 / $398.05 / $398.05	Facility		$398.05	$398.05	$398.05
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $48.90 / $84.40 / $120.00	Facility		$48.90	$84.40	$120.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $244.00	Facility		$35.00	$35.00	$244.00
HealthNet Facility/Professional Facility Modifier Low / Median / High Price $1,560.31 / $1,560.31 / $1,560.31	Facility		$1,560.31	$1,560.31	$1,560.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $118.50 / $195.00 / $315.00	Facility		$118.50	$195.00	$315.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $244.00	Facility		$35.00	$35.00	$244.00