Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $414.26 / $1,168.70	Facility		$207.13	$414.26	$1,168.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $208.19 / $331.02	Professional		$207.13	$208.19	$331.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.74 / $330.85 / $741.65	Facility		$219.74	$330.85	$741.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.13 / $213.91 / $453.09	Professional		$206.13	$213.91	$453.09
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.70 / $100.00 / $293.10	Facility		$77.70	$100.00	$293.10
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $211.04 / $211.04 / $496.21	Professional		$211.04	$211.04	$496.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.40 / $195.40 / $207.13	Facility		$195.40	$195.40	$207.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $247.50	Professional		$207.13	$207.13	$247.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $204.90 / $205.04 / $276.61	Professional		$204.90	$205.04	$276.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.42 / $248.56 / $455.69	Professional		$186.42	$248.56	$455.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $272.74 / $1,025.20 / $1,035.65	Facility		$272.74	$1,025.20	$1,035.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $904.64 / $904.64 / $904.64	Professional		$904.64	$904.64	$904.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $420.04 / $420.04 / $420.04	Professional		$420.04	$420.04	$420.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $215.41 / $352.51	Facility		$207.13	$215.41	$352.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $256.13	Professional		$207.13	$207.13	$256.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $165.70 / $207.13 / $310.69	Professional		$165.70	$207.13	$310.69
United Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $219.56 / $397.90	Professional		$207.13	$219.56	$397.90