Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.54 / $203.54 / $336.43	Facility		$114.54	$203.54	$336.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $150.97 / $654.89	Professional		$114.54	$150.97	$654.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.90 / $182.95 / $410.12	Facility		$102.90	$182.95	$410.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.70 / $114.54 / $418.69	Professional		$97.70	$114.54	$418.69
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.20 / $100.00 / $573.60	Facility		$77.20	$100.00	$573.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $286.41	Professional		$114.54	$114.54	$286.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $108.05 / $114.54	Facility		$108.05	$108.05	$114.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $114.54	Professional		$114.54	$114.54	$114.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.09 / $137.44 / $289.00	Professional		$103.09	$137.44	$289.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $520.79 / $642.04 / $642.04	Facility		$520.79	$642.04	$642.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.05 / $114.54 / $163.79	Facility		$108.05	$114.54	$163.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $247.75	Professional		$114.54	$114.54	$247.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $228.56 / $228.56 / $228.56	Professional		$228.56	$228.56	$228.56
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $91.63 / $125.99 / $194.71	Professional		$91.63	$125.99	$194.71
United Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $114.54 / $294.70	Professional		$114.54	$114.54	$294.70