Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $128.82 / $354.81	Facility		$28.18	$128.82	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $28.84 / $199.53	Professional		$14.45	$28.84	$199.53
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $72.44 / $107.15 / $204.17	Professional	CQ	$72.44	$107.15	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $95.50 / $239.88	Facility		$77.62	$95.50	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $57.54 / $123.03	Professional		$25.70	$57.54	$123.03
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $95.50 / $218.78	Facility		$52.48	$95.50	$218.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.65 / $100.00	Professional		$33.11	$43.65	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $85.11 / $316.23	Facility		$72.44	$85.11	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $85.11	Professional		$26.92	$40.74	$85.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $17.78 / $58.88	Professional		$13.49	$17.78	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $72.44	Professional		$33.11	$41.69	$72.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $234.42 / $309.03	Professional		$45.71	$234.42	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $19.50 / $70.79	Professional		$15.49	$19.50	$70.79
Optum Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $39.81	Professional		$30.90	$30.90	$39.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $41.69 / $63.10	Facility		$25.70	$41.69	$63.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $91.20	Professional		$26.30	$41.69	$91.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $28.84 / $42.66	Professional		$16.60	$28.84	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $77.62	Professional		$30.20	$39.81	$77.62