Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.09 / $173.09 / $173.09	Facility		$173.09	$173.09	$173.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.83 / $173.09 / $177.26	Professional		$166.83	$173.09	$177.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.76 / $205.69 / $348.01	Facility		$172.76	$205.69	$348.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.26 / $186.12 / $333.24	Professional		$177.26	$186.12	$333.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.26 / $177.26 / $177.26	Facility		$177.26	$177.26	$177.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.26 / $177.26 / $177.26	Professional		$177.26	$177.26	$177.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $212.09 / $212.09 / $318.14	Professional		$212.09	$212.09	$318.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $393.93 / $801.00	Professional		$129.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $198.11 / $417.08 / $782.03	Facility		$198.11	$417.08	$782.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $792.45 / $792.45 / $938.43	Professional		$792.45	$792.45	$938.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $233.29	Professional		$60.00	$60.00	$233.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $168.92 / $177.26 / $378.38	Facility		$168.92	$177.26	$378.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.26 / $177.26 / $177.26	Professional		$177.26	$177.26	$177.26
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $212.09 / $212.09 / $275.72	Professional		$212.09	$212.09	$275.72
United Facility/Professional Professional Modifier Low / Median / High Price $675.67 / $675.67 / $675.67	Professional		$675.67	$675.67	$675.67