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 $334.95 / $625.64 / $938.46	Professional		$334.95	$625.64	$938.46
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $620.90 / $1,399.90	Facility		$97.00	$620.90	$1,399.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.16 / $761.62 / $2,474.58	Facility		$166.16	$761.62	$2,474.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $268.82 / $335.00	Professional		$200.00	$268.82	$335.00
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 $954.18 / $1,093.20 / $1,093.20	Facility		$954.18	$1,093.20	$1,093.20
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 $217.07 / $448.66 / $687.19	Facility		$217.07	$448.66	$687.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $268.01 / $335.00	Professional		$200.00	$268.01	$335.00
United Facility/Professional Facility Modifier Low / Median / High Price $386.87 / $386.87 / $623.75	Facility		$386.87	$386.87	$623.75
United Facility/Professional Professional Modifier Low / Median / High Price $282.14 / $376.18 / $941.02	Professional		$282.14	$376.18	$941.02