Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.37 / $628.25 / $1,657.29	Facility		$187.37	$628.25	$1,657.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $178.37 / $205.37	Professional		$29.53	$178.37	$205.37
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 $114.32 / $155.97 / $185.28	Professional		$114.32	$155.97	$185.28
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 $151.10 / $321.56 / $681.32	Facility		$151.10	$321.56	$681.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $34.50 / $58.23	Professional		$26.25	$34.50	$58.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $638.07 / $801.00	Professional		$393.93	$638.07	$801.00
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 $1,157.43 / $1,157.43 / $1,157.43	Professional		$1,157.43	$1,157.43	$1,157.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $85.00 / $85.00	Professional		$60.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.63 / $61.56 / $316.81	Facility		$40.63	$61.56	$316.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $34.50 / $58.23	Professional		$26.25	$34.50	$58.23
United Facility/Professional Facility Modifier Low / Median / High Price $38.28 / $38.28 / $38.28	Facility		$38.28	$38.28	$38.28
United Facility/Professional Professional Modifier Low / Median / High Price $148.79 / $194.16 / $462.13	Professional		$148.79	$194.16	$462.13