Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.43 / $100.43 / $120.51	Facility		$100.43	$100.43	$120.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $100.43 / $102.85	Professional		$96.80	$100.43	$102.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.24 / $119.35 / $201.93	Facility		$100.24	$119.35	$201.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $115.32 / $206.91	Professional		$102.85	$115.32	$206.91
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $44.29 / $62.18 / $89.15	Facility		$44.29	$62.18	$89.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $30.00 / $75.02	Professional		$21.00	$30.00	$75.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Facility		$102.85	$102.85	$102.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Professional		$102.85	$102.85	$102.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $638.07 / $801.00	Professional		$129.00	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $114.95 / $242.00 / $453.75	Facility		$114.95	$242.00	$453.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $459.80 / $459.80 / $544.50	Professional		$459.80	$459.80	$544.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $85.00 / $85.00	Professional		$70.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $96.80 / $121.00 / $121.00	Facility		$96.80	$121.00	$121.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $137.50	Professional		$102.85	$102.85	$137.50
United Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $110.00 / $224.53	Professional		$110.00	$110.00	$224.53