Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.00 / $245.00 / $1,110.57	Facility		$245.00	$245.00	$1,110.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.88 / $245.00 / $1,110.57	Professional		$132.88	$245.00	$1,110.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.75 / $249.30 / $876.00	Facility		$153.75	$249.30	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $508.81 / $976.56	Professional		$150.00	$508.81	$976.56
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $84.84 / $115.56 / $219.82	Facility		$84.84	$115.56	$219.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $200.00 / $286.02	Professional		$140.00	$200.00	$286.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.83 / $74.17 / $180.59	Facility		$36.83	$74.17	$180.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.30 / $144.30 / $144.30	Professional		$144.30	$144.30	$144.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $99.00 / $99.00	Professional		$99.00	$99.00	$99.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $393.93 / $885.00	Professional		$144.00	$393.93	$885.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.07 / $134.24 / $1,110.57	Facility		$57.07	$134.24	$1,110.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $144.30 / $2,400,000.00 / $2,400,000.00	Professional		$144.30	$2,400,000.00	$2,400,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $20.12 / $20.12 / $35.77	Professional		$20.12	$20.12	$35.77