Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $112.20	Professional		$104.71	$109.65	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $87.10 / $218.78	Facility		$69.18	$87.10	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $128.82	Professional		$69.18	$75.86	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $831.76	Professional		$120.23	$131.83	$831.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Professional		$588.84	$588.84	$588.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $239.88	Facility		$104.71	$120.23	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $416.87 / $416.87	Professional		$131.83	$416.87	$416.87