Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $169.06 / $438.67	Facility		$84.57	$169.06	$438.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $85.42 / $145.22	Professional		$84.57	$85.42	$145.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.72 / $135.08 / $302.81	Facility		$89.72	$135.08	$302.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $87.71 / $199.35	Professional		$84.53	$87.71	$199.35
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $75.90 / $83.82 / $100.00	Facility		$75.90	$83.82	$100.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $86.17 / $86.17 / $191.30	Professional		$86.17	$86.17	$191.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.78 / $79.78 / $84.57	Facility		$79.78	$79.78	$84.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $98.61	Professional		$84.57	$84.57	$98.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $117.63 / $158.56	Professional		$117.45	$117.63	$158.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.11 / $101.48 / $191.65	Professional		$76.11	$101.48	$191.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $518.54 / $588.15	Facility		$112.49	$518.54	$588.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $518.54 / $518.54 / $518.54	Professional		$518.54	$518.54	$518.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.97 / $158.55 / $240.77	Professional		$120.97	$158.55	$240.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $88.80 / $145.38	Facility		$84.57	$88.80	$145.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $142.76	Professional		$84.57	$84.57	$142.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.66 / $84.57 / $126.86	Professional		$67.66	$84.57	$126.86
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $160.80	Professional		$84.57	$84.57	$160.80