Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $371.54 / $630.96	Facility		$93.33	$371.54	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $109.65 / $154.88	Professional		$14.13	$109.65	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $95.50 / $239.88	Facility		$77.62	$95.50	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $263.03	Professional		$75.86	$128.82	$263.03
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $309.03	Professional		$117.49	$158.49	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $85.11	Facility		$72.44	$72.44	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $346.74	Professional		$91.20	$141.25	$346.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $346.74	Professional		$144.54	$169.82	$346.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,071.52 / $1,071.52	Facility		$229.09	$1,071.52	$1,071.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $1,380.38	Professional		$169.82	$229.09	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Optum Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $39.81	Professional		$30.90	$30.90	$39.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $147.91 / $251.19	Facility		$87.10	$147.91	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $346.74	Professional		$87.10	$141.25	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $323.59	Professional		$107.15	$151.36	$323.59