Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.24 / $163.24 / $163.24	Facility		$163.24	$163.24	$163.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.24 / $163.24 / $212.21	Professional		$163.24	$163.24	$212.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.68 / $201.65 / $230.84	Facility		$164.68	$201.65	$230.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.58 / $192.05 / $341.27	Professional		$141.58	$192.05	$341.27
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $75.50 / $96.60 / $192.05	Facility		$75.50	$96.60	$192.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $182.45 / $452.48	Professional		$182.45	$182.45	$452.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.39 / $179.39 / $179.39	Facility		$179.39	$179.39	$179.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.39 / $179.39 / $179.39	Professional		$179.39	$179.39	$179.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $192.00 / $404.00	Professional		$175.00	$192.00	$404.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $218.32 / $492.01 / $596.22	Facility		$218.32	$492.01	$596.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $179.39 / $179.39 / $233.43	Facility		$179.39	$179.39	$233.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.90 / $179.39 / $179.39	Professional		$114.90	$179.39	$179.39
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $160.26 / $208.34 / $272.44	Professional		$160.26	$208.34	$272.44
United Facility/Professional Professional Modifier Low / Median / High Price $178.51 / $192.05 / $339.10	Professional		$178.51	$192.05	$339.10