Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $289.30 / $697.12 / $766.83	Facility		$289.30	$697.12	$766.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.66 / $289.30 / $289.30	Professional		$96.66	$289.30	$289.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $254.06 / $311.08 / $356.13	Facility		$254.06	$311.08	$356.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.63 / $296.27 / $702.18	Professional		$198.63	$296.27	$702.18
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $893.17 / $1,594.94	Facility		$98.20	$893.17	$1,594.94
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $207.38 / $503.34	Professional		$144.54	$207.38	$503.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Facility		$128.69	$128.69	$128.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Professional		$128.69	$128.69	$128.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $525.62 / $525.62 / $630.74	Professional		$525.62	$525.62	$630.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $300.73 / $828.37 / $858.56	Facility		$300.73	$828.37	$858.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,015.51 / $1,015.51 / $1,323.83	Professional		$1,015.51	$1,015.51	$1,323.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $345.26	Professional		$85.00	$85.00	$345.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $313.06 / $413.91	Facility		$128.69	$313.06	$413.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $128.69 / $331.13	Professional		$128.69	$128.69	$331.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $525.62 / $578.17 / $893.55	Professional		$525.62	$578.17	$893.55
United Facility/Professional Professional Modifier Low / Median / High Price $259.31 / $259.31 / $528.78	Professional		$259.31	$259.31	$528.78