Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $77.62	Facility		$66.07	$66.07	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $85.11	Professional		$57.54	$67.61	$85.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.13 / $15.14	Facility		$14.13	$14.13	$15.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $63.10 / $165.96	Professional		$14.45	$63.10	$165.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $204.17	Professional		$100.00	$107.15	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $194.98	Professional		$70.79	$95.50	$194.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $43.65	Professional		$36.31	$36.31	$43.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $831.76	Professional		$109.65	$117.49	$831.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Professional		$575.44	$575.44	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $74.13	Professional		$67.61	$67.61	$74.13
Optum Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $128.82	Professional		$66.07	$95.50	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $79.43 / $123.03	Facility		$63.10	$79.43	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $186.21	Professional		$70.79	$93.33	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $165.96	Professional		$57.54	$79.43	$165.96