Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $75.28 / $210.06	Facility		$36.67	$75.28	$210.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $37.04 / $98.67	Professional		$36.67	$37.04	$98.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.61 / $42.21 / $52.80	Facility		$34.61	$42.21	$52.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $38.45 / $127.39	Professional		$36.67	$38.45	$127.39
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $52.77 / $61.47 / $156.15	Facility		$52.77	$61.47	$156.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.78 / $41.77 / $100.00	Professional		$39.78	$41.77	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.59 / $34.59 / $36.67	Facility		$34.59	$34.59	$36.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $51.89	Professional		$36.67	$36.67	$51.89
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $51.48 / $63.18	Professional		$46.80	$51.48	$63.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $44.00 / $80.67	Professional		$33.00	$44.00	$80.67
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $92.70 / $788.44 / $875.51	Facility		$92.70	$788.44	$875.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,062.00 / $1,379.87 / $1,435.07	Professional		$1,062.00	$1,379.87	$1,435.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $95.94 / $95.94	Professional		$46.80	$95.94	$95.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $47.94 / $371.86	Facility		$36.67	$47.94	$371.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $58.50	Professional		$36.67	$36.67	$58.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $67.04 / $67.04 / $67.04	Professional		$67.04	$67.04	$67.04
United Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $71.98	Professional		$36.67	$36.67	$71.98