Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.07 / $126.07 / $177.84	Facility		$126.07	$126.07	$177.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.54 / $126.07 / $126.07	Professional		$96.54	$126.07	$126.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.38 / $155.11 / $175.74	Facility		$145.38	$155.11	$175.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.62 / $146.21 / $274.87	Professional		$68.62	$146.21	$274.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $107.73 / $153.90 / $375.16	Professional		$107.73	$153.90	$375.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $58.65 / $58.65	Professional		$58.65	$58.65	$58.65
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 $100.00 / $100.00 / $213.75	Facility		$100.00	$100.00	$213.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $185.89 / $185.89 / $185.89	Professional		$185.89	$185.89	$185.89
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 $96.72 / $126.07 / $180.57	Facility		$96.72	$126.07	$180.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $58.65 / $58.65	Professional		$58.65	$58.65	$58.65