Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $147.91 / $380.19	Facility		$60.26	$147.91	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $60.26 / $85.11	Professional		$57.54	$60.26	$85.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $72.44 / $141.25	Facility		$64.57	$72.44	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $117.49	Professional		$61.66	$69.18	$117.49
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $67.61 / $85.11	Facility		$60.26	$67.61	$85.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $131.83	Professional		$60.26	$72.44	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $398.11 / $831.76	Professional		$128.82	$398.11	$831.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $79.43 / $109.65	Facility		$58.88	$79.43	$109.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $74.13	Professional		$61.66	$61.66	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $85.11	Professional		$60.26	$60.26	$85.11