Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.03 / $94.45 / $141.72	Facility		$92.03	$94.45	$141.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $93.25 / $110.43	Professional		$92.03	$93.25	$110.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.57 / $83.57 / $89.02	Professional		$83.57	$83.57	$89.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.90 / $34.70 / $39.15	Facility		$29.90	$34.70	$39.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.63 / $40.64 / $138.87	Professional		$29.63	$40.64	$138.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $82.85 / $106.70 / $260.10	Professional		$82.85	$106.70	$260.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.16 / $109.16 / $109.16	Facility		$109.16	$109.16	$109.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $86.90 / $86.90	Professional		$86.90	$86.90	$86.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.83 / $138.55 / $237.25	Professional		$97.83	$138.55	$237.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $166.77 / $498.64 / $498.64	Facility		$166.77	$498.64	$498.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $599.65 / $599.65 / $802.58	Professional		$599.65	$599.65	$802.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.00 / $85.00	Professional		$32.34	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.03 / $118.69 / $167.42	Facility		$92.03	$118.69	$167.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $86.90 / $242.26	Professional		$86.90	$86.90	$242.26
United Facility/Professional Professional Modifier Low / Median / High Price $71.40 / $94.35 / $212.51	Professional		$71.40	$94.35	$212.51