Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $831.76	Professional		$74.13	$91.20	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $123.03 / $524.81	Facility		$104.71	$123.03	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $173.78	Professional		$75.86	$102.33	$173.78
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $239.88	Professional		$95.50	$138.04	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $204.17	Professional		$81.28	$107.15	$204.17
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $35.48 / $41.69	Professional		$27.54	$35.48	$41.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $245.47	Professional		$100.00	$158.49	$245.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $758.58	Professional		$575.44	$758.58	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $16.22	Professional		$16.22	$16.22	$16.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $112.20 / $169.82	Facility		$81.28	$112.20	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $190.55	Professional		$79.43	$104.71	$190.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $338.84	Professional		$27.54	$41.69	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $169.82	Professional		$63.10	$85.11	$169.82