Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.52 / $145.96 / $384.93	Facility		$43.52	$145.96	$384.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.45 / $43.52 / $51.82	Professional		$29.45	$43.52	$51.82
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 $42.49 / $241.80 / $376.63	Professional		$42.49	$241.80	$376.63
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $158.33 / $362.25	Facility		$91.00	$158.33	$362.25
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.89 / $325.55 / $681.32	Facility		$168.89	$325.55	$681.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.81 / $26.06 / $32.64	Professional		$23.81	$26.06	$32.64
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 $85.00 / $296.60 / $296.60	Facility		$85.00	$296.60	$296.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $269.37 / $269.37 / $269.37	Professional		$269.37	$269.37	$269.37
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 $39.33 / $204.64 / $570.84	Facility		$39.33	$204.64	$570.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.97 / $26.06 / $32.68	Professional		$23.97	$26.06	$32.68
United Facility/Professional Professional Modifier Low / Median / High Price $35.53 / $45.11 / $114.45	Professional		$35.53	$45.11	$114.45