Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $549.54 / $831.76	Facility		$478.63	$549.54	$831.76
Ambetter Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $707.95 / $1,096.48	Facility		$398.11	$707.95	$1,096.48
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 $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
HealthNet Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,168.69 / $25,118.86	Facility		$4,073.80	$4,168.69	$25,118.86
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 $457.09 / $891.25 / $1,513.56	Facility		$457.09	$891.25	$1,513.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $891.25 / $1,513.56	Facility		$457.09	$891.25	$1,513.56