Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.31 / $253.31 / $282.77	Facility		$253.31	$253.31	$282.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.77 / $366.10 / $691.89	Professional		$282.77	$366.10	$691.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.32 / $70.23 / $185.71	Facility		$58.32	$70.23	$185.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $532.37 / $699.31 / $1,185.79	Professional		$532.37	$699.31	$1,185.79
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $109.29 / $195.17	Facility		$92.60	$109.29	$195.17
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $766.38 / $1,121.77 / $1,646.21	Professional		$766.38	$1,121.77	$1,646.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $643.37 / $643.37 / $1,068.75	Professional		$643.37	$643.37	$1,068.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $638.07 / $801.00	Professional		$393.93	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,135.36 / $4,141.80 / $4,292.81	Facility		$1,135.36	$4,141.80	$4,292.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,018.27 / $4,018.27 / $6,619.13	Professional		$4,018.27	$4,018.27	$6,619.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $189.21 / $189.21 / $189.21	Professional		$189.21	$189.21	$189.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.34 / $461.46 / $1,189.85	Facility		$60.34	$461.46	$1,189.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $643.37 / $643.37	Professional		$77.73	$643.37	$643.37
United Facility/Professional Professional Modifier Low / Median / High Price $338.95 / $388.47 / $820.51	Professional		$338.95	$388.47	$820.51