Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.86 / $200.86 / $200.86	Facility		$200.86	$200.86	$200.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.60 / $200.86 / $205.70	Professional		$193.60	$200.86	$205.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.04 / $85.88 / $193.60	Professional		$63.04	$85.88	$193.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Facility		$205.70	$205.70	$205.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.70 / $205.70 / $205.70	Professional		$205.70	$205.70	$205.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.00 / $393.93 / $801.00	Professional		$127.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $229.90 / $484.00 / $907.50	Facility		$229.90	$484.00	$907.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $919.60 / $961.40 / $1,089.00	Professional		$919.60	$961.40	$1,089.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.64 / $205.70 / $242.00	Facility		$105.64	$205.70	$242.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $205.70 / $205.70 / $275.00	Professional		$205.70	$205.70	$275.00
United Facility/Professional Professional Modifier Low / Median / High Price $220.00 / $220.00 / $422.62	Professional		$220.00	$220.00	$422.62