Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $209.90 / $244.01	Facility		$104.73	$209.90	$244.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $105.78 / $241.04	Professional		$104.73	$105.78	$241.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.57 / $167.29 / $375.00	Facility		$107.57	$167.29	$375.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.95 / $252.94	Professional		$104.73	$104.95	$252.94
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $143.30	Facility		$77.09	$100.00	$143.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $106.71 / $106.71 / $263.79	Professional		$106.71	$106.71	$263.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $98.80 / $104.73	Facility		$98.80	$98.80	$104.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.26 / $125.68 / $279.63	Professional		$94.26	$125.68	$279.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $133.68 / $502.50 / $523.65	Facility		$133.68	$502.50	$523.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $104.73 / $148.78	Facility		$98.80	$104.73	$148.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $226.53	Professional		$104.73	$104.73	$226.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $163.76 / $163.76 / $163.76	Professional		$163.76	$163.76	$163.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $115.20 / $178.04	Professional		$83.78	$115.20	$178.04
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $226.32	Professional		$104.73	$104.73	$226.32