Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $66.07 / $102.33	Facility		$46.77	$66.07	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $213.80	Professional		$63.10	$87.10	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $79.43 / $251.19	Professional		$70.79	$79.43	$251.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $79.43 / $147.91	Facility		$67.61	$79.43	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $74.13 / $134.90	Professional		$63.10	$74.13	$134.90
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $70.79 / $85.11	Facility		$63.10	$70.79	$85.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $199.53	Professional		$70.79	$93.33	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $398.11	Professional		$72.44	$102.33	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $95.50 / $194.98	Facility		$72.44	$95.50	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $162.18	Professional		$70.79	$77.62	$162.18