Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.31 / $62.83 / $77.61	Facility		$57.31	$62.83	$77.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.37 / $61.00 / $83.43	Professional		$51.37	$61.00	$83.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $56.30 / $56.30	Professional		$41.92	$56.30	$56.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.88 / $83.73 / $83.73	Facility		$77.88	$83.73	$83.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $76.48 / $149.43	Professional		$50.45	$76.48	$149.43
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $34.03 / $97.93 / $130.26	Facility		$34.03	$97.93	$130.26
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $87.43 / $131.80	Professional		$61.20	$87.43	$131.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $61.74 / $109.96	Professional		$44.00	$61.74	$109.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $59.03 / $92.44	Professional		$52.92	$59.03	$92.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $261.89 / $284.72 / $284.72	Facility		$261.89	$284.72	$284.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $372.52 / $417.10 / $472.73	Professional		$372.52	$417.10	$472.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.00 / $85.00	Professional		$32.34	$60.00	$85.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $47.70 / $125.34	Professional		$43.46	$47.70	$125.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.95 / $70.09 / $98.98	Facility		$53.95	$70.09	$98.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $58.00 / $104.17	Professional		$43.00	$58.00	$104.17
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $115.00	Facility		$45.00	$45.00	$115.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $47.70 / $125.34	Professional		$43.46	$47.70	$125.34
United Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $129.60 / $129.60	Facility		$67.00	$129.60	$129.60
United Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $69.87 / $224.85	Professional		$47.52	$69.87	$224.85