Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.25 / $150.00 / $165.00	Facility		$62.25	$150.00	$165.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $62.25 / $106.01	Professional		$51.75	$62.25	$106.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.31 / $108.04 / $242.19	Facility		$66.31	$108.04	$242.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $63.75 / $185.76	Professional		$62.50	$63.75	$185.76
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $62.00 / $73.50 / $190.72	Facility		$62.00	$73.50	$190.72
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $62.25 / $154.38	Professional		$62.25	$62.25	$154.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Facility		$63.75	$63.75	$63.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Professional		$63.75	$63.75	$63.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $775.00 / $1,117.00	Professional		$393.93	$775.00	$1,117.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,199.84 / $2,551.37 / $2,813.76	Facility		$2,199.84	$2,551.37	$2,813.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $89.16	Facility		$63.75	$63.75	$89.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $400.36 / $3,670.68	Professional		$63.75	$400.36	$3,670.68
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $160.81	Professional		$62.50	$62.50	$160.81