Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.08 / $495.04 / $1,285.96	Facility		$229.08	$495.04	$1,285.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.10 / $229.08 / $234.60	Professional		$48.10	$229.08	$234.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.17 / $246.33 / $281.99	Facility		$201.17	$246.33	$281.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $234.60 / $316.70	Professional		$57.66	$234.60	$316.70
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.29 / $99.00 / $155.60	Facility		$77.29	$99.00	$155.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $58.75 / $60.51 / $131.38	Professional		$58.75	$60.51	$131.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $57.66 / $57.66	Facility		$57.66	$57.66	$57.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $76.20	Professional		$57.66	$57.66	$76.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $283.26 / $638.07 / $801.00	Professional		$283.26	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $276.00 / $1,219.00 / $1,219.00	Facility		$276.00	$1,219.00	$1,219.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,311.00 / $1,311.00 / $1,311.00	Professional		$1,311.00	$1,311.00	$1,311.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $125.29 / $125.29	Professional		$60.00	$125.29	$125.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $91.80 / $276.00	Facility		$57.66	$91.80	$276.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $234.60	Professional		$57.66	$57.66	$234.60
United Facility/Professional Facility Modifier Low / Median / High Price $174.90 / $184.32 / $184.32	Facility		$174.90	$184.32	$184.32
United Facility/Professional Professional Modifier Low / Median / High Price $276.00 / $276.00 / $462.52	Professional		$276.00	$276.00	$462.52