Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.83 / $395.66 / $1,120.58	Facility		$197.83	$395.66	$1,120.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $199.81 / $339.95	Professional		$197.83	$199.81	$339.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $209.88 / $315.99 / $708.35	Facility		$209.88	$315.99	$708.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.65 / $205.11 / $466.15	Professional		$197.65	$205.11	$466.15
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $100.00 / $226.79	Facility		$77.40	$100.00	$226.79
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $201.56 / $201.56 / $447.46	Professional		$201.56	$201.56	$447.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.63 / $186.63 / $197.83	Facility		$186.63	$186.63	$197.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $214.63	Professional		$197.83	$197.83	$214.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $193.86 / $194.08 / $261.72	Professional		$193.86	$194.08	$261.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $178.05 / $237.40 / $431.27	Professional		$178.05	$237.40	$431.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $258.16 / $970.40 / $989.15	Facility		$258.16	$970.40	$989.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $855.93 / $855.93 / $855.93	Professional		$855.93	$855.93	$855.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $397.41 / $397.41 / $397.41	Professional		$397.41	$397.41	$397.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $197.83 / $205.75 / $337.09	Facility		$197.83	$205.75	$337.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $242.33	Professional		$197.83	$197.83	$242.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $158.27 / $197.83 / $296.75	Professional		$158.27	$197.83	$296.75
United Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $203.80 / $380.86	Professional		$197.83	$203.80	$380.86