Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.40 / $148.40 / $308.67	Facility		$148.40	$148.40	$308.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.37 / $148.40 / $229.41	Professional		$123.37	$148.40	$229.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.84 / $151.97 / $424.66	Facility		$125.84	$151.97	$424.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.03 / $151.97 / $296.81	Professional		$112.03	$151.97	$296.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $75.90 / $97.00 / $175.22	Facility		$75.90	$97.00	$175.22
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $148.40 / $148.40 / $329.45	Professional		$148.40	$148.40	$329.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.97 / $151.97 / $151.97	Facility		$151.97	$151.97	$151.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.97 / $151.97 / $151.97	Professional		$151.97	$151.97	$151.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.00 / $190.00 / $393.93	Professional		$164.00	$190.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $178.80 / $178.80 / $670.50	Facility		$178.80	$178.80	$670.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.97 / $151.97 / $212.21	Facility		$151.97	$151.97	$212.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.97 / $151.97 / $151.97	Professional		$151.97	$151.97	$151.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $111.26 / $144.63 / $189.14	Professional		$111.26	$144.63	$189.14
United Facility/Professional Professional Modifier Low / Median / High Price $219.12 / $219.12 / $317.95	Professional		$219.12	$219.12	$317.95