Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $162.18 / $208.93	Facility		$114.82	$162.18	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $186.21	Professional		$77.62	$77.62	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $95.50 / $204.17	Facility		$83.18	$95.50	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $199.53	Professional		$77.62	$83.18	$199.53
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $87.10 / $147.91	Facility		$77.62	$87.10	$147.91
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $102.33 / $234.42	Professional		$77.62	$102.33	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $77.62	Facility		$72.44	$72.44	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $85.11 / $169.82	Professional		$69.18	$85.11	$169.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $117.49 / $194.98	Facility		$77.62	$117.49	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $95.50	Professional		$77.62	$77.62	$95.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $131.83	Professional		$61.66	$85.11	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $199.53 / $199.53	Facility		$77.62	$199.53	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $177.83	Professional		$77.62	$77.62	$177.83