Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.42 / $47.42 / $47.42	Facility		$47.42	$47.42	$47.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $47.42 / $48.56	Professional		$45.70	$47.42	$48.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.47 / $170.83 / $289.04	Facility		$143.47	$170.83	$289.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.24 / $150.00 / $369.52	Professional		$92.24	$150.00	$369.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $78.31 / $111.89 / $230.01	Professional		$78.31	$111.89	$230.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Facility		$48.56	$48.56	$48.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $48.56 / $48.56	Professional		$48.56	$48.56	$48.56
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 $147.22 / $181.78 / $520.84	Facility		$147.22	$181.78	$520.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $486.12 / $548.62 / $625.01	Professional		$486.12	$548.62	$625.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $198.74 / $206.10 / $301.80	Professional		$198.74	$206.10	$301.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.42 / $147.22 / $147.22	Facility		$47.42	$147.22	$147.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $48.56 / $176.68	Professional		$48.56	$48.56	$176.68
United Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $57.13 / $107.03	Professional		$57.13	$57.13	$107.03