Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.79 / $1,024.00 / $2,610.00	Facility		$201.79	$1,024.00	$2,610.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.38 / $211.49 / $275.00	Professional		$185.38	$211.49	$275.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $716.00 / $1,396.00 / $4,019.00	Facility		$716.00	$1,396.00	$4,019.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.15 / $330.74 / $491.97	Professional		$212.15	$330.74	$491.97
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $183.80 / $414.40	Facility		$95.50	$183.80	$414.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.44 / $290.02 / $756.65	Facility		$147.44	$290.02	$756.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $267.43 / $400.00	Professional		$200.00	$267.43	$400.00
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 $404.32 / $2,613.82 / $2,613.82	Facility		$404.32	$2,613.82	$2,613.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,293.17 / $1,293.17 / $1,679.48	Professional		$1,293.17	$1,293.17	$1,679.48
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 $195.24 / $268.98 / $391.22	Facility		$195.24	$268.98	$391.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $265.00 / $335.00	Professional		$200.00	$265.00	$335.00
United Facility/Professional Facility Modifier Low / Median / High Price $114.39 / $114.39 / $229.70	Facility		$114.39	$114.39	$229.70
United Facility/Professional Professional Modifier Low / Median / High Price $83.33 / $118.61 / $277.26	Professional		$83.33	$118.61	$277.26