Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $151.36 / $257.04	Facility		$87.10	$151.36	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $416.87	Professional		$141.25	$165.96	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $223.87	Professional		$109.65	$109.65	$223.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $186.21 / $346.74	Facility		$158.49	$186.21	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $316.23	Professional		$147.91	$177.83	$316.23
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $100.00 / $199.53	Facility		$83.18	$100.00	$199.53
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $218.78 / $457.09	Professional		$165.96	$218.78	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $302.00 / $537.03	Professional		$165.96	$302.00	$537.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $213.80 / $436.52	Facility		$151.36	$213.80	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $380.19	Professional		$158.49	$177.83	$380.19