Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.65 / $280.83 / $330.40	Facility		$124.65	$280.83	$330.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $124.65 / $212.28	Professional		$103.62	$124.65	$212.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.46 / $134.03 / $153.44	Facility		$109.46	$134.03	$153.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $127.65 / $243.01	Professional		$63.43	$127.65	$243.01
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $97.40 / $150.18	Facility		$75.70	$97.40	$150.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $124.65 / $124.65 / $309.13	Professional		$124.65	$124.65	$309.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.43 / $63.43 / $63.43	Facility		$63.43	$63.43	$63.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $63.43 / $63.43	Professional		$63.43	$63.43	$63.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $150.18 / $663.30 / $663.30	Facility		$150.18	$663.30	$663.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.43 / $63.43 / $178.25	Facility		$63.43	$63.43	$178.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $64.70 / $152.88	Professional		$63.43	$64.70	$152.88
United Facility/Professional Professional Modifier Low / Median / High Price $125.15 / $125.15 / $266.54	Professional		$125.15	$125.15	$266.54