Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.14 / $76.56 / $193.90	Facility		$23.14	$76.56	$193.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.34 / $27.64 / $99.69	Professional		$21.34	$27.64	$99.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $25.83 / $54.70	Professional		$19.96	$25.83	$54.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.67 / $293.00 / $876.00	Facility		$33.67	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.54 / $40.13 / $76.41	Professional		$24.54	$40.13	$76.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $25.09 / $60.16	Professional		$17.55	$25.09	$60.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Facility		$26.30	$26.30	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.53 / $32.72 / $73.26	Professional		$25.53	$32.72	$73.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.06 / $25.27 / $34.06	Professional		$21.06	$25.27	$34.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.37 / $24.89 / $59.00	Professional		$20.37	$24.89	$59.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.13 / $90.12 / $111.53	Facility		$54.13	$90.12	$111.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $151.44 / $182.48	Professional		$151.44	$151.44	$182.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.13 / $27.68 / $36.58	Facility		$21.13	$27.68	$36.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.81 / $34.90 / $63.79	Professional		$25.81	$34.90	$63.79
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $27.37 / $35.79	Professional		$20.39	$27.37	$35.79
United Facility/Professional Professional Modifier Low / Median / High Price $20.16 / $27.90 / $59.19	Professional		$20.16	$27.90	$59.19