Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $966.70 / $966.70 / $966.70	Facility		$966.70	$966.70	$966.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $690.30 / $966.70 / $1,103.86	Professional		$690.30	$966.70	$1,103.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.82 / $165.42 / $435.65	Facility		$136.82	$165.42	$435.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $806.67 / $1,287.00 / $2,396.52	Professional		$806.67	$1,287.00	$2,396.52
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $237.83 / $423.46	Facility		$95.50	$237.83	$423.46
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $671.31 / $924.35 / $1,538.23	Professional		$671.31	$924.35	$1,538.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.54 / $845.38 / $845.38	Facility		$84.54	$845.38	$845.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $718.57 / $718.57 / $845.38	Professional		$718.57	$718.57	$845.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $801.00 / $1,242.00	Professional		$393.93	$801.00	$1,242.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $76.00 / $5,143.63 / $5,331.16	Facility		$76.00	$5,143.63	$5,331.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,990.22 / $4,990.22 / $8,220.23	Professional		$4,990.22	$4,990.22	$8,220.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $102.54 / $210.20	Professional		$60.00	$102.54	$210.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.01 / $777.85 / $1,459.06	Facility		$98.01	$777.85	$1,459.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.97 / $718.57 / $845.38	Professional		$108.97	$718.57	$845.38
United Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $89.71 / $386.93	Professional		$65.62	$89.71	$386.93