Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.95 / $239.88	Facility		$19.05	$19.95	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $19.95 / $37.15	Professional		$16.98	$19.95	$37.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $13.18 / $23.99	Professional		$12.88	$13.18	$23.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $19.95 / $50.12	Facility		$15.85	$19.95	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $21.38 / $43.65	Professional		$16.22	$21.38	$43.65
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $309.03 / $398.11	Facility		$97.72	$309.03	$398.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $26.30 / $45.71	Professional		$20.42	$26.30	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $204.17 / $501.19	Facility		$144.54	$204.17	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.30 / $50.12	Professional		$19.95	$26.30	$50.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $40.74	Professional		$30.20	$33.11	$40.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $46.77	Professional		$21.38	$26.92	$46.77
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $173.78	Professional		$120.23	$173.78	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
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 $18.20 / $27.54 / $41.69	Facility		$18.20	$27.54	$41.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.18 / $51.29	Professional		$20.42	$28.18	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $218.78 / $338.84	Facility		$208.93	$218.78	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $21.38 / $42.66	Professional		$15.85	$21.38	$42.66