Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $169.82 / $218.78	Facility		$123.03	$169.82	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $190.55	Professional		$81.28	$81.28	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $97.72 / $213.80	Facility		$85.11	$97.72	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $83.18 / $234.42	Professional		$81.28	$83.18	$234.42
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $89.13 / $177.83	Facility		$79.43	$89.13	$177.83
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $229.09	Professional		$81.28	$104.71	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $81.28	Facility		$75.86	$75.86	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $89.13 / $186.21	Professional		$72.44	$89.13	$186.21
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $123.03 / $204.17	Facility		$81.28	$123.03	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $85.11	Professional		$81.28	$81.28	$85.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $138.04	Professional		$64.57	$89.13	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $181.97	Professional		$81.28	$81.28	$181.97