Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $85.92 / $205.42	Facility		$25.00	$85.92	$205.42
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 / $171.91 / $876.00	Facility		$15.62	$171.91	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.83 / $21.68 / $49.83	Professional		$14.83	$21.68	$49.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $47.49 / $87.59 / $197.66	Facility		$47.49	$87.59	$197.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $26.51 / $58.74	Professional		$19.23	$26.51	$58.74
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 / $21.32 / $74.84	Professional		$12.18	$21.32	$74.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $23.96	Professional		$19.97	$19.97	$23.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.00 / $124.00 / $393.93	Professional		$56.00	$124.00	$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 $18.57 / $32.58 / $55.81	Facility		$18.57	$32.58	$55.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.37 / $21.35 / $78.43	Professional		$12.37	$21.35	$78.43
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $28.65 / $48.70	Professional		$19.97	$28.65	$48.70
United Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $15.31 / $78.61	Professional		$9.27	$15.31	$78.61