Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $69.18 / $239.88	Professional		$57.54	$69.18	$239.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $117.49 / $562.34	Facility		$95.50	$117.49	$562.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $194.98	Professional		$93.33	$117.49	$194.98
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $208.93	Professional		$74.13	$104.71	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $190.55	Professional		$72.44	$100.00	$190.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $75.86	Professional		$63.10	$63.10	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $338.84 / $645.65	Professional		$128.82	$338.84	$645.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $83.18 / $141.25	Facility		$63.10	$83.18	$141.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $190.55	Professional		$74.13	$102.33	$190.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $93.33	Professional		$57.54	$64.57	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $154.88	Professional		$58.88	$83.18	$154.88