Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.10 / $143.10 / $143.10	Facility		$143.10	$143.10	$143.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $143.10 / $198.47	Professional		$115.01	$143.10	$198.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.50 / $21.16 / $55.74	Facility		$17.50	$21.16	$55.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.90 / $190.21 / $675.10	Professional		$143.90	$190.21	$675.10
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $28.28 / $45.32 / $64.45	Facility		$28.28	$45.32	$64.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $0.48 / $192.93 / $331.53	Professional		$0.48	$192.93	$331.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $147.10 / $147.10	Facility		$64.00	$147.10	$147.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $125.04 / $147.10	Professional		$107.38	$125.04	$147.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $283.26 / $638.07 / $801.00	Professional		$283.26	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $76.00 / $280.19 / $761.52	Facility		$76.00	$280.19	$761.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $543.62 / $959.04 / $959.04	Professional		$543.62	$959.04	$959.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $60.00 / $64.26	Professional		$31.35	$60.00	$64.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $46.04 / $167.40	Facility		$32.36	$46.04	$167.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.14 / $107.38 / $147.10	Professional		$24.14	$107.38	$147.10
United Facility/Professional Professional Modifier Low / Median / High Price $11.78 / $14.84 / $44.46	Professional		$11.78	$14.84	$44.46