Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $123.03 / $154.88	Facility		$64.57	$123.03	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $123.03 / $263.03	Professional		$61.66	$123.03	$263.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $77.62 / $194.98	Facility		$61.66	$77.62	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $107.15 / $208.93	Professional		$66.07	$107.15	$208.93
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $104.71 / $218.78	Professional		$0.02	$104.71	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $194.98	Professional		$72.44	$95.50	$194.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $38.90	Professional		$25.70	$32.36	$38.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $263.03 / $398.11	Professional		$72.44	$263.03	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Optum Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $407.38	Professional		$72.44	$85.11	$407.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $104.71 / $173.78	Facility		$74.13	$104.71	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $190.55	Professional		$72.44	$102.33	$190.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $74.13	Professional		$32.36	$45.71	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $208.93	Professional		$60.26	$81.28	$208.93