Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.52 / $134.52 / $134.52	Facility		$134.52	$134.52	$134.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.66 / $134.52 / $137.77	Professional		$129.66	$134.52	$137.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.87 / $171.95 / $207.98	Facility		$145.87	$171.95	$207.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $175.84 / $406.82	Professional		$162.08	$175.84	$406.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $98.88	Professional		$40.00	$40.00	$98.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $162.08 / $162.08	Facility		$162.08	$162.08	$162.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $162.08	Professional		$162.08	$162.08	$162.08
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 $162.08 / $162.08 / $163.61	Facility		$162.08	$162.08	$163.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $238.54 / $238.54 / $238.54	Professional		$238.54	$238.54	$238.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $221.56 / $336.44	Professional		$70.00	$221.56	$336.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.52 / $162.08 / $162.08	Facility		$134.52	$162.08	$162.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $162.08	Professional		$162.08	$162.08	$162.08
United Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $292.08	Professional		$162.08	$162.08	$292.08