Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $64.57 / $64.57	Facility		$57.54	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $109.65	Professional		$60.26	$79.43	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $12.88 / $32.36	Facility		$10.23	$12.88	$32.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $371.54	Professional		$81.28	$102.33	$371.54
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $26.30 / $42.66	Facility		$12.88	$26.30	$42.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $158.49 / $213.80	Professional		$147.91	$158.49	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $147.91	Facility		$114.82	$114.82	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $154.88	Professional		$100.00	$100.00	$154.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $204.17	Professional		$169.82	$169.82	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $831.76	Professional		$100.00	$131.83	$831.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $660.69 / $660.69	Facility		$138.04	$660.69	$660.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $10.96 / $10.96	Professional		$10.96	$10.96	$10.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $165.96	Professional		$15.14	$15.14	$165.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $79.43 / $169.82	Facility		$12.88	$79.43	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $102.33	Professional		$57.54	$102.33	$102.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $288.40	Professional		$169.82	$223.87	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $5.75 / $40.74 / $77.62	Facility		$5.75	$40.74	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $141.25	Professional		$50.12	$72.44	$141.25