Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.36 / $359.04 / $422.40	Facility		$159.36	$359.04	$422.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $159.36 / $271.39	Professional		$132.47	$159.36	$271.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.88 / $177.60 / $230.40	Facility		$146.88	$177.60	$230.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $163.19 / $328.32	Professional		$160.00	$163.19	$328.32
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $98.70 / $192.00	Facility		$76.20	$98.70	$192.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $159.36 / $159.36 / $395.21	Professional		$159.36	$159.36	$395.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Facility		$163.19	$163.19	$163.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $385.00 / $525.00	Professional		$240.00	$385.00	$525.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $831.65 / $831.65	Facility		$192.00	$831.65	$831.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $227.88	Facility		$163.19	$163.19	$227.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $208.00 / $272.00	Professional		$160.00	$208.00	$272.00
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $329.76	Professional		$160.00	$160.00	$329.76