Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $549.54 / $812.83	Facility		$478.63	$549.54	$812.83
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $100.00	Facility		$87.10	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
HealthNet Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $28,840.32	Facility		$3,388.44	$3,388.44	$28,840.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $223.87 / $575.44	Facility		$134.90	$223.87	$575.44
Optum Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $524.81 / $758.58	Facility		$416.87	$524.81	$758.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $524.81 / $758.58	Facility		$398.11	$524.81	$758.58