Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.81 / $242.19 / $761.52	Facility		$105.81	$242.19	$761.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $105.81 / $974.40	Professional		$96.00	$105.81	$974.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.52 / $117.93 / $152.99	Facility		$97.52	$117.93	$152.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.24 / $108.36 / $211.62	Professional		$106.24	$108.36	$211.62
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $58.53 / $65.03 / $158.52	Professional		$58.53	$65.03	$158.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.36 / $108.36 / $108.36	Facility		$108.36	$108.36	$108.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $108.36 / $108.36	Professional		$108.36	$108.36	$108.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $89.33 / $107.20	Professional		$89.33	$89.33	$107.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.00 / $294.00 / $438.00	Professional		$194.00	$294.00	$438.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $149.86 / $254.96 / $431.25	Facility		$149.86	$254.96	$431.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $437.00 / $484.42 / $517.50	Professional		$437.00	$484.42	$517.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.81 / $127.48 / $191.54	Facility		$105.81	$127.48	$191.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $108.36 / $127.48	Professional		$108.36	$108.36	$127.48
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $98.26 / $151.86	Professional		$89.33	$98.26	$151.86
United Facility/Professional Professional Modifier Low / Median / High Price $106.24 / $106.24 / $205.70	Professional		$106.24	$106.24	$205.70