Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.22 / $57.22 / $57.22	Facility		$57.22	$57.22	$57.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $57.22 / $58.60	Professional		$55.15	$57.22	$58.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $58.60 / $65.48	Professional		$55.15	$58.60	$65.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Facility		$58.60	$58.60	$58.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $58.60 / $58.60	Professional		$58.60	$58.60	$58.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $21.00 / $638.07	Professional		$12.00	$21.00	$638.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $137.88 / $258.52	Facility		$80.00	$137.88	$258.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $261.97 / $261.97 / $310.23	Professional		$261.97	$261.97	$310.23
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 $57.22 / $68.94 / $68.94	Facility		$57.22	$68.94	$68.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $58.60 / $82.73	Professional		$58.60	$58.60	$82.73
United Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $68.94 / $132.43	Professional		$68.94	$68.94	$132.43