Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $181.97 / $239.88	Facility		$131.83	$181.97	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $144.54	Professional		$87.10	$87.10	$144.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $104.71 / $263.03	Facility		$91.20	$104.71	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $218.78	Professional		$87.10	$91.20	$218.78
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $89.13 / $194.98	Facility		$83.18	$89.13	$194.98
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $239.88	Professional		$87.10	$112.20	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $87.10	Facility		$83.18	$83.18	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $190.55	Professional		$77.62	$95.50	$190.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $131.83 / $218.78	Facility		$87.10	$131.83	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $91.20	Professional		$87.10	$87.10	$91.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $147.91	Professional		$69.18	$95.50	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $257.04 / $257.04	Facility		$87.10	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $204.17	Professional		$87.10	$87.10	$204.17