Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.08 / $254.08 / $2,104.04	Facility		$192.08	$254.08	$2,104.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.22 / $254.08 / $260.20	Professional		$211.22	$254.08	$260.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.18 / $283.16 / $367.34	Facility		$234.18	$283.16	$367.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.01 / $260.20 / $499.58	Professional		$52.01	$260.20	$499.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $5.00 / $12.50	Professional		$4.00	$5.00	$12.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $260.20 / $260.20 / $260.20	Facility		$260.20	$260.20	$260.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $260.20 / $260.20	Professional		$260.20	$260.20	$260.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $235.61 / $235.61 / $282.73	Professional		$235.61	$235.61	$282.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $292.00 / $443.00 / $660.00	Professional		$292.00	$443.00	$660.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $338.08 / $612.24 / $1,093.28	Facility		$338.08	$612.24	$1,093.28
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,107.84 / $1,163.26 / $1,311.93	Professional		$1,107.84	$1,163.26	$1,311.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $91.61	Professional		$85.00	$85.00	$91.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $254.08 / $306.12 / $363.51	Facility		$254.08	$306.12	$363.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $260.20 / $302.06	Professional		$260.20	$260.20	$302.06
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $235.61 / $259.17 / $400.54	Professional		$235.61	$259.17	$400.54
United Facility/Professional Professional Modifier Low / Median / High Price $255.10 / $255.10 / $477.90	Professional		$255.10	$255.10	$477.90