Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $309.03 / $776.25	Facility		$125.89	$309.03	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $123.03 / $151.36	Professional		$120.23	$123.03	$151.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $154.88 / $309.03	Facility		$131.83	$154.88	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $257.04	Professional		$128.82	$128.82	$257.04
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $100.00 / $186.21	Facility		$83.18	$100.00	$186.21
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $446.68	Professional		$125.89	$162.18	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $177.83 / $346.74	Facility		$128.82	$177.83	$346.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $213.80	Professional		$125.89	$162.18	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $977.24 / $977.24	Facility		$131.83	$977.24	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $302.00	Professional		$125.89	$125.89	$302.00