Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.64 / $303.60 / $1,398.00	Facility		$84.64	$303.60	$1,398.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.05 / $39.00 / $107.00	Professional		$16.05	$39.00	$107.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $20.00 / $23.95 / $39.00	Professional	25	$20.00	$23.95	$39.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.27 / $13.27 / $13.27	Professional		$13.27	$13.27	$13.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.00 / $524.00 / $3,398.00	Facility		$221.00	$524.00	$3,398.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $28.97 / $53.15	Professional		$14.70	$28.97	$53.15
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $47.80 / $86.60 / $169.28	Facility		$47.80	$86.60	$169.28
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $22.84 / $26.79 / $64.94	Professional		$22.84	$26.79	$64.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.73 / $93.00 / $264.93	Facility		$72.73	$93.00	$264.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $25.65 / $48.99	Professional		$18.73	$25.65	$48.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.70 / $17.60 / $38.36	Professional		$13.70	$17.60	$38.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $30.75 / $106.29 / $106.29	Facility		$30.75	$106.29	$106.29
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $21.53 / $78.05	Professional		$18.98	$21.53	$78.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $6.00 / $35.69 / $93.00	Facility		$6.00	$35.69	$93.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $20.95 / $48.99	Professional		$14.70	$20.95	$48.99
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $46.67 / $46.67	Professional		$46.67	$46.67	$46.67
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $15.29 / $26.24 / $40.42	Professional		$15.29	$26.24	$40.42
United Facility/Professional Facility Modifier Low / Median / High Price $113.16 / $117.34 / $180.39	Facility		$113.16	$117.34	$180.39
United Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $22.41 / $50.93	Professional		$12.00	$22.41	$50.93