Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $202.98 / $227.87	Facility		$102.94	$202.98	$227.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $103.96 / $174.36	Professional		$102.94	$103.96	$174.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.53 / $164.41 / $368.55	Facility		$105.53	$164.41	$368.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $102.94 / $239.35	Professional		$101.49	$102.94	$239.35
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.20 / $100.00 / $230.40	Facility		$77.20	$100.00	$230.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $104.88 / $104.88 / $262.25	Professional		$104.88	$104.88	$262.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $97.11 / $102.94	Facility		$97.11	$97.11	$102.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.65 / $123.53 / $238.00	Professional		$92.65	$123.53	$238.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $161.65 / $697.75 / $697.75	Facility		$161.65	$697.75	$697.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $102.94 / $146.03	Facility		$97.11	$102.94	$146.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $222.66	Professional		$102.94	$102.94	$222.66
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $82.35 / $111.64 / $172.53	Professional		$82.35	$111.64	$172.53
United Facility/Professional Facility Modifier Low / Median / High Price $102.93 / $102.93 / $102.93	Facility		$102.93	$102.93	$102.93
United Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $238.08	Professional		$102.94	$102.94	$238.08