Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.63 / $545.32 / $1,438.46	Facility		$162.63	$545.32	$1,438.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.94 / $158.44 / $193.38	Professional		$31.94	$158.44	$193.38
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 $136.88 / $161.12 / $226.07	Professional		$136.88	$161.12	$226.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $158.33 / $264.45	Facility		$91.00	$158.33	$264.45
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 $135.05 / $288.36 / $454.14	Facility		$135.05	$288.36	$454.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.06 / $28.42 / $35.52	Professional		$26.06	$28.42	$35.52
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 $1,006.55 / $1,006.55 / $1,006.55	Professional		$1,006.55	$1,006.55	$1,006.55
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 $45.80 / $202.09 / $433.71	Facility		$45.80	$202.09	$433.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.18 / $28.42 / $35.75	Professional		$26.18	$28.42	$35.75
United Facility/Professional Professional Modifier Low / Median / High Price $132.72 / $168.54 / $429.11	Professional		$132.72	$168.54	$429.11