Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $630.96	Facility		$269.15	$269.15	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $912.01	Professional		$251.19	$323.59	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $263.03	Professional		$257.04	$257.04	$263.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $338.84 / $707.95	Facility		$295.12	$338.84	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $645.65	Professional		$251.19	$288.40	$645.65
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $100.00 / $363.08	Facility		$85.11	$100.00	$363.08
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $776.25	Professional		$275.42	$346.74	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $295.12 / $588.84	Professional		$239.88	$295.12	$588.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $389.05 / $724.44	Facility		$269.15	$389.05	$724.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $457.09	Professional		$213.80	$295.12	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $257.04	Facility		$245.47	$245.47	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $588.84	Professional		$269.15	$288.40	$588.84