Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $363.08 / $436.52	Facility		$100.00	$363.08	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $302.00	Professional		$85.11	$109.65	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $125.89	Professional		$81.28	$97.72	$125.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $138.04 / $154.88	Facility		$112.20	$138.04	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $218.78	Professional		$104.71	$138.04	$218.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $257.04	Professional		$95.50	$123.03	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $147.91	Facility		$131.83	$131.83	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $223.87	Professional		$93.33	$128.82	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $190.55	Professional		$83.18	$123.03	$190.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $154.88	Professional		$56.23	$93.33	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $125.89 / $194.98	Facility		$85.11	$125.89	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $245.47	Professional		$93.33	$131.83	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $199.53	Professional		$81.28	$112.20	$199.53