Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $101.08 / $206.64	Facility		$25.00	$101.08	$206.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.67 / $25.00 / $37.42	Professional		$19.67	$25.00	$37.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.62 / $486.00 / $876.00	Facility		$15.62	$486.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.83 / $21.30 / $45.26	Professional		$14.83	$21.30	$45.26
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $73.33 / $116.95	Facility		$33.22	$73.33	$116.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $8.68 / $11.96 / $26.49	Professional		$8.68	$11.96	$26.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $0.87 / $2.57 / $106.90	Facility		$0.87	$2.57	$106.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.18 / $20.28 / $74.84	Professional		$12.18	$20.28	$74.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $16.64 / $19.98	Professional		$16.64	$16.64	$19.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $134.00 / $393.93	Professional		$60.00	$134.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $48.83 / $139.41 / $150.53	Facility		$48.83	$139.41	$150.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $221.32 / $221.32 / $221.32	Professional		$221.32	$221.32	$221.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $116.58 / $166.55	Professional		$60.00	$116.58	$166.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $10.11 / $32.24 / $55.81	Facility		$10.11	$32.24	$55.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.18 / $20.28 / $80.78	Professional		$12.18	$20.28	$80.78
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $23.88 / $40.60	Professional		$16.64	$23.88	$40.60
United Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $15.31 / $76.53	Professional		$9.27	$15.31	$76.53