Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.95 / $177.95 / $177.95	Facility		$177.95	$177.95	$177.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.52 / $177.95 / $182.24	Professional		$171.52	$177.95	$182.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.61 / $211.47 / $357.79	Facility		$177.61	$211.47	$357.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $191.35 / $340.78	Professional		$182.24	$191.35	$340.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.24 / $182.24 / $182.24	Facility		$182.24	$182.24	$182.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $182.24 / $182.24	Professional		$182.24	$182.24	$182.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $638.07 / $801.00	Professional		$129.00	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $203.68 / $428.80 / $804.00	Facility		$203.68	$428.80	$804.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $814.72 / $814.72 / $964.80	Professional		$814.72	$814.72	$964.80
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 $173.66 / $182.24 / $389.00	Facility		$173.66	$182.24	$389.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $182.24 / $182.24	Professional		$182.24	$182.24	$182.24
United Facility/Professional Professional Modifier Low / Median / High Price $694.66 / $694.66 / $694.66	Professional		$694.66	$694.66	$694.66