Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $111.46	Facility		$30.00	$30.00	$111.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $44.00	Professional		$30.00	$30.00	$44.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.53 / $28.53 / $38.04	Professional		$28.53	$28.53	$38.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $49.45 / $142.06	Facility		$30.00	$49.45	$142.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $41.29 / $41.29	Professional		$33.32	$41.29	$41.29
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $88.77 / $100.00 / $163.97	Professional		$88.77	$100.00	$163.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.68 / $14.68 / $14.68	Professional		$14.68	$14.68	$14.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $41.84 / $51.35	Professional		$38.04	$41.84	$51.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.24 / $47.55 / $87.49	Professional		$34.24	$47.55	$87.49
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $178.03 / $180.69	Facility		$80.00	$178.03	$180.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $189.44 / $189.44 / $285.30	Professional		$189.44	$189.44	$285.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $54.18 / $79.33	Professional		$52.24	$54.18	$79.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.80 / $38.04 / $48.01	Facility		$31.80	$38.04	$48.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.68 / $14.68 / $44.32	Professional		$14.68	$14.68	$44.32
United Facility/Professional Professional Modifier Low / Median / High Price $22.16 / $22.16 / $62.28	Professional		$22.16	$22.16	$62.28