Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.60 / $258.08 / $410.73	Facility		$124.60	$258.08	$410.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.35 / $124.60 / $233.87	Professional		$123.35	$124.60	$233.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.37 / $141.99 / $177.64	Facility		$122.37	$141.99	$177.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $135.97 / $298.89	Professional		$123.36	$135.97	$298.89
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $98.70 / $156.46	Facility		$76.20	$98.70	$156.46
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.69 / $125.69 / $314.29	Professional		$125.69	$125.69	$314.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.38 / $116.38 / $123.36	Facility		$116.38	$116.38	$123.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $123.36 / $123.36	Professional		$123.36	$123.36	$123.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.02 / $148.03 / $279.56	Professional		$111.02	$148.03	$279.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $164.10 / $505.07 / $505.07	Facility		$164.10	$505.07	$505.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $116.38 / $123.36 / $174.95	Facility		$116.38	$123.36	$174.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $123.36 / $266.83	Professional		$123.36	$123.36	$266.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $205.88 / $205.88 / $205.88	Professional		$205.88	$205.88	$205.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $98.69 / $135.69 / $209.72	Professional		$98.69	$135.69	$209.72
United Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $123.36 / $253.07	Professional		$123.36	$123.36	$253.07