Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $4,786.30 / $12,022.64	Facility		$275.42	$4,786.30	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $64.57 / $8,511.38	Professional		$54.95	$64.57	$8,511.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $70.79 / $141.25	Facility		$61.66	$70.79	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $112.20	Professional		$58.88	$66.07	$112.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $199.53	Professional		$70.79	$95.50	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $93.33	Professional		$69.18	$69.18	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $245.47	Professional		$61.66	$69.18	$245.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $69.18 / $147.91	Facility		$57.54	$69.18	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $117.49	Professional		$60.26	$60.26	$117.49