Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.80 / $56.50 / $153.47	Facility		$50.80	$56.50	$153.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $126.87 / $166.51	Professional		$52.49	$126.87	$166.51
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $242.42 / $367.36 / $367.36	Facility		$242.42	$367.36	$367.36
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $61.51 / $112.97 / $196.79	Professional		$61.51	$112.97	$196.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $128.26 / $179.40	Professional		$128.26	$128.26	$179.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $141.83 / $141.83 / $170.20	Professional		$141.83	$141.83	$170.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.59 / $135.62 / $198.17	Professional		$61.59	$135.62	$198.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $348.93 / $348.93 / $348.93	Facility		$348.93	$348.93	$348.93
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $935.43 / $935.43 / $1,187.55	Professional		$935.43	$935.43	$1,187.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.00 / $85.00	Professional		$32.34	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.92 / $119.78 / $185.39	Facility		$54.92	$119.78	$185.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $138.47 / $363.72	Professional		$128.26	$138.47	$363.72
United Facility/Professional Professional Modifier Low / Median / High Price $110.04 / $161.13 / $565.66	Professional		$110.04	$161.13	$565.66