Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $59.40 / $264.99	Facility		$42.13	$59.40	$264.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $84.26	Professional		$42.13	$42.13	$84.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.07 / $25.28 / $26.33	Professional		$21.07	$25.28	$26.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.37 / $211.07 / $876.00	Facility		$44.37	$211.07	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.85 / $42.13 / $63.19	Professional		$16.85	$42.13	$63.19
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $30.46 / $93.95 / $118.81	Facility		$30.46	$93.95	$118.81
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1.40 / $2.00 / $7.55	Professional		$1.40	$2.00	$7.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.93 / $50.56 / $106.51	Facility		$28.93	$50.56	$106.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.81 / $42.13 / $60.50	Professional		$23.81	$42.13	$60.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $99.00	Professional		$42.13	$42.13	$99.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $42.13 / $91.84	Professional		$33.70	$42.13	$91.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $67.41 / $200.12 / $200.12	Facility		$67.41	$200.12	$200.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.43 / $42.13 / $74.98	Facility		$39.43	$42.13	$74.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.32 / $40.02 / $52.97	Professional		$25.32	$40.02	$52.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $42.13 / $58.98	Professional		$33.70	$42.13	$58.98
United Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $17.69 / $64.45	Professional		$17.69	$17.69	$64.45