Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.25 / $103.55 / $1,380.90	Facility		$92.25	$103.55	$1,380.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $148.66 / $187.06	Professional		$84.50	$148.66	$187.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.37 / $293.00 / $876.00	Facility		$63.37	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.92 / $773.64 / $1,589.48	Professional		$185.92	$773.64	$1,589.48
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $426.90 / $838.65	Facility		$97.00	$426.90	$838.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $186.94 / $267.06 / $595.05	Professional		$186.94	$267.06	$595.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.46 / $325.41 / $1,180.43	Facility		$200.46	$325.41	$1,180.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $259.08 / $532.88	Professional		$150.00	$259.08	$532.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $221.87 / $221.87 / $266.24	Professional		$221.87	$221.87	$266.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $226.78 / $302.38 / $628.00	Professional		$226.78	$302.38	$628.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $403.45 / $744.78 / $871.09	Facility		$403.45	$744.78	$871.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $999.25 / $1,109.75 / $1,625.70	Professional		$999.25	$1,109.75	$1,625.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.03 / $247.85 / $386.27	Facility		$97.03	$247.85	$386.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $175.34 / $286.54 / $467.97	Professional		$175.34	$286.54	$467.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $257.51 / $289.70 / $377.17	Professional		$257.51	$289.70	$377.17
United Facility/Professional Facility Modifier Low / Median / High Price $289.56 / $289.56 / $289.56	Facility		$289.56	$289.56	$289.56
United Facility/Professional Professional Modifier Low / Median / High Price $82.71 / $195.21 / $587.75	Professional		$82.71	$195.21	$587.75