Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $239.88	Professional		$194.98	$199.53	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $194.98	Professional		$81.28	$125.89	$194.98
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $134.90	Professional		$95.50	$125.89	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $199.53 / $239.88	Professional		$177.83	$199.53	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $269.15	Professional		$131.83	$173.78	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $239.88 / $309.03	Facility		$165.96	$239.88	$309.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $239.88	Professional		$125.89	$125.89	$239.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $204.17	Professional		$147.91	$147.91	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $245.47	Professional		$125.89	$218.78	$245.47