Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.38 / $100.38 / $100.38	Facility		$100.38	$100.38	$100.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $100.38 / $102.80	Professional		$96.75	$100.38	$102.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.19 / $119.29 / $201.83	Facility		$100.19	$119.29	$201.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.65 / $102.80 / $237.59	Professional		$77.65	$102.80	$237.59
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $97.90 / $120.94	Facility		$76.20	$97.90	$120.94
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.38 / $100.38 / $222.84	Professional		$100.38	$100.38	$222.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Facility		$102.80	$102.80	$102.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
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 $120.94 / $241.88 / $453.53	Facility		$120.94	$241.88	$453.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $459.57 / $459.57 / $544.23	Professional		$459.57	$459.57	$544.23
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 $100.38 / $120.94 / $120.94	Facility		$100.38	$120.94	$120.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $151.18	Professional		$102.80	$102.80	$151.18
United Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $100.78 / $188.80	Professional		$100.78	$100.78	$188.80