Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $42.00 / $42.00	Facility		$42.00	$42.00	$42.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $42.00 / $87.20	Professional		$42.00	$42.00	$87.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.07 / $40.07 / $53.42	Professional		$40.07	$40.07	$53.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $69.45 / $199.50	Facility		$47.25	$69.45	$199.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $60.11 / $63.00	Professional		$45.00	$60.11	$63.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $115.96 / $193.78	Professional		$100.00	$115.96	$193.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $39.75 / $39.75	Professional		$39.75	$39.75	$39.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $53.42 / $58.76 / $72.12	Professional		$53.42	$58.76	$72.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $66.78 / $122.87	Professional		$48.08	$66.78	$122.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $82.98 / $250.01 / $253.75	Facility		$82.98	$250.01	$253.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $266.02 / $266.02 / $400.65	Professional		$266.02	$266.02	$400.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.52 / $70.00 / $105.57	Professional		$69.52	$70.00	$105.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.52 / $53.42 / $67.42	Facility		$44.52	$53.42	$67.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $39.75 / $62.23	Professional		$39.75	$39.75	$62.23
United Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $31.12 / $81.15	Professional		$31.12	$31.12	$81.15