Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.79 / $21.79 / $183.04	Facility		$21.79	$21.79	$183.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $21.79 / $22.31	Professional		$18.11	$21.79	$22.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.19 / $23.67 / $26.82	Facility		$22.19	$23.67	$26.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $32.34 / $349.20	Professional		$22.31	$32.34	$349.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $21.90 / $54.76	Professional		$17.52	$21.90	$54.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.33 / $174.33 / $174.33	Facility		$174.33	$174.33	$174.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.33 / $174.33 / $174.33	Professional		$174.33	$174.33	$174.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $407.40 / $1,122.17 / $1,163.08	Facility		$407.40	$1,122.17	$1,163.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,375.72 / $1,375.72 / $1,793.40	Professional		$1,375.72	$1,375.72	$1,793.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $22.31 / $206.83 / $463.75	Facility		$22.31	$206.83	$463.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $174.33 / $174.33 / $174.33	Professional		$174.33	$174.33	$174.33
United Facility/Professional Professional Modifier Low / Median / High Price $136.19 / $152.66 / $465.34	Professional		$136.19	$152.66	$465.34