Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $230.76 / $255.59 / $255.59	Facility		$230.76	$255.59	$255.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.46 / $236.85 / $281.56	Professional		$214.46	$236.85	$281.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.00 / $486.00 / $876.00	Facility		$203.00	$486.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.26 / $230.74 / $234.27	Professional		$138.26	$230.74	$234.27
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $1,904.45	Facility		$66.09	$100.00	$1,904.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $250.00 / $609.42	Professional		$175.00	$250.00	$609.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.30 / $248.34 / $310.62	Professional		$227.30	$248.34	$310.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $638.66 / $4,042.45 / $4,042.45	Facility		$638.66	$4,042.45	$4,042.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,523.18 / $1,557.45 / $2,512.19	Professional		$1,523.18	$1,557.45	$2,512.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $221.39 / $370.19 / $466.47	Facility		$221.39	$370.19	$466.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $228.54 / $248.34 / $311.92	Professional		$228.54	$248.34	$311.92
United Facility/Professional Facility Modifier Low / Median / High Price $1,372.92 / $1,372.92 / $1,372.92	Facility		$1,372.92	$1,372.92	$1,372.92
United Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $282.30 / $815.25	Professional		$193.25	$282.30	$815.25