Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $81.28	Professional		$52.48	$70.79	$81.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $354.81	Facility		$112.20	$141.25	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $151.36	Professional		$81.28	$151.36	$151.36
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $257.04	Professional		$107.15	$151.36	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $85.11	Professional		$70.79	$70.79	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $93.33 / $144.54	Professional		$81.28	$93.33	$144.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $851.14 / $851.14	Professional		$549.54	$851.14	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $158.49	Professional		$79.43	$79.43	$158.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $120.23 / $194.98	Facility		$75.86	$120.23	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $117.49	Professional		$47.86	$47.86	$117.49
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $123.03	Professional		$70.79	$85.11	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $57.54 / $112.20	Professional		$45.71	$57.54	$112.20