Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $52.48	Facility		$48.98	$48.98	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $95.50	Professional		$48.98	$67.61	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $125.89	Professional		$87.10	$109.65	$125.89
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 $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
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 $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $165.96 / $251.19	Facility		$69.18	$165.96	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
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 $91.20 / $125.89 / $162.18	Professional		$91.20	$125.89	$162.18