Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.40 / $992.25 / $4,990.00	Facility		$68.40	$992.25	$4,990.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $66.95 / $219.32	Professional		$57.03	$66.95	$219.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.76 / $119.53 / $4,164.00	Facility		$22.76	$119.53	$4,164.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $107.36 / $202.20	Professional		$77.95	$107.36	$202.20
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,689.00 / $2,230.00	Facility		$100.00	$1,689.00	$2,230.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.53 / $73.98 / $169.06	Professional		$60.53	$73.98	$169.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.88 / $232.18 / $472.45	Facility		$182.88	$232.18	$472.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.48 / $97.23 / $235.52	Professional		$61.48	$97.23	$235.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $350.00 / $11,981.00	Professional		$61.00	$350.00	$11,981.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $251.11 / $683.34 / $683.34	Facility		$251.11	$683.34	$683.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $810.52 / $810.52 / $1,066.50	Professional		$810.52	$810.52	$1,066.50
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 $81.56 / $172.35 / $269.17	Facility		$81.56	$172.35	$269.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $106.06 / $257.70	Professional		$62.50	$106.06	$257.70
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $12.50 / $12.50 / $12.50	Professional		$12.50	$12.50	$12.50
United Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $123.15 / $328.31	Professional		$50.30	$123.15	$328.31