Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $228.96 / $367.61	Facility		$112.45	$228.96	$367.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $138.52 / $701.55	Professional		$112.45	$138.52	$701.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.34 / $179.62 / $402.64	Facility		$117.34	$179.62	$402.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $114.48 / $328.05	Professional		$112.45	$114.48	$328.05
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.20 / $100.00 / $432.75	Facility		$77.20	$100.00	$432.75
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $281.18	Professional		$112.45	$112.45	$281.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $106.09 / $112.45	Facility		$106.09	$106.09	$112.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.21 / $134.94 / $274.00	Professional		$101.21	$134.94	$274.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $407.91 / $701.55 / $701.55	Facility		$407.91	$701.55	$701.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $112.45 / $160.80	Facility		$106.09	$112.45	$160.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $243.23	Professional		$112.45	$112.45	$243.23
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $249.75 / $249.75 / $249.75	Professional		$249.75	$249.75	$249.75
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.96 / $123.70 / $191.17	Professional		$89.96	$123.70	$191.17
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $308.17	Professional		$112.45	$112.45	$308.17