Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $140.75 / $368.79	Facility		$140.75	$140.75	$368.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $140.75 / $239.70	Professional		$140.75	$140.75	$239.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.69 / $224.82 / $503.97	Facility		$149.69	$224.82	$503.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.37 / $173.08 / $345.19	Professional		$147.37	$173.08	$345.19
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $191.45	Facility		$77.09	$100.00	$191.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $164.43 / $164.43 / $406.47	Professional		$164.43	$164.43	$406.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.82 / $161.82 / $161.82	Facility		$161.82	$161.82	$161.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.82 / $161.82 / $161.82	Professional		$161.82	$161.82	$161.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.68 / $168.90 / $318.97	Professional		$126.68	$168.90	$318.97
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $323.39 / $389.68 / $624.29	Facility		$323.39	$389.68	$624.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $161.82 / $201.27	Facility		$140.75	$161.82	$201.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $161.82 / $161.82	Professional		$140.75	$161.82	$161.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $250.54 / $250.54 / $250.54	Professional		$250.54	$250.54	$250.54
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $112.60 / $154.83 / $239.28	Professional		$112.60	$154.83	$239.28
United Facility/Professional Professional Modifier Low / Median / High Price $156.33 / $173.08 / $297.77	Professional		$156.33	$173.08	$297.77