Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.21 / $205.55 / $512.42	Facility		$87.21	$205.55	$512.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $87.21 / $104.65	Professional		$84.06	$87.21	$104.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.38 / $98.15 / $126.09	Facility		$80.38	$98.15	$126.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.80 / $89.31 / $170.05	Professional		$78.80	$89.31	$170.05
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $73.40 / $89.31 / $122.92	Facility		$73.40	$89.31	$122.92
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.21 / $89.31 / $202.88	Professional		$87.21	$89.31	$202.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.31 / $89.31 / $151.57	Facility		$89.31	$89.31	$151.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $89.31	Professional		$89.31	$89.31	$89.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.00 / $638.07	Professional		$100.00	$177.00	$638.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $99.82 / $445.80 / $445.80	Facility		$99.82	$445.80	$445.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $399.27 / $399.27 / $472.82	Professional		$399.27	$399.27	$472.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.21 / $105.07 / $107.30	Facility		$87.21	$105.07	$107.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $89.31 / $109.45	Professional		$89.31	$89.31	$109.45
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $87.56 / $168.57	Professional		$87.56	$87.56	$168.57