Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.41 / $57.25 / $65.67	Facility		$28.41	$57.25	$65.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $58.96 / $69.01	Professional		$40.26	$58.96	$69.01
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 $62.83 / $3,804.27 / $5,849.06	Professional		$62.83	$3,804.27	$5,849.06
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $55.96 / $85.55 / $126.01	Facility		$55.96	$85.55	$126.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $69.70 / $74.86	Professional		$48.79	$69.70	$74.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.79 / $59.23 / $141.82	Facility		$45.79	$59.23	$141.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.67 / $94.12 / $294.64	Professional		$84.67	$94.12	$294.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.56 / $71.58 / $124.28	Professional		$58.56	$71.58	$124.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $130.63 / $137.24 / $327.51	Facility		$130.63	$137.24	$327.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $359.53 / $359.53 / $528.53	Professional		$359.53	$359.53	$528.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.39 / $77.87 / $97.49	Facility		$55.39	$77.87	$97.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $81.54 / $109.50	Professional		$65.06	$81.54	$109.50
United Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $65.00 / $147.65	Professional		$47.04	$65.00	$147.65