Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $433.48 / $1,125.06	Facility		$216.90	$433.48	$1,125.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $218.91 / $372.36	Professional		$216.90	$218.91	$372.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $230.11 / $346.45 / $776.63	Facility		$230.11	$346.45	$776.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.74 / $224.92 / $511.18	Professional		$216.74	$224.92	$511.18
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $249.90	Facility		$77.09	$100.00	$249.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $221.00 / $221.00 / $490.62	Professional		$221.00	$221.00	$490.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.63 / $204.63 / $216.90	Facility		$204.63	$204.63	$216.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $235.32	Professional		$216.90	$216.90	$235.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $212.00 / $212.12 / $286.36	Professional		$212.00	$212.12	$286.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $195.21 / $260.27 / $433.80	Professional		$195.21	$260.27	$433.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $282.00 / $1,060.00 / $1,084.50	Facility		$282.00	$1,060.00	$1,084.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $936.51 / $936.51 / $936.51	Professional		$936.51	$936.51	$936.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.48 / $286.36 / $434.84	Professional		$218.48	$286.36	$434.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $225.58 / $369.59	Facility		$216.90	$225.58	$369.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $265.14	Professional		$216.90	$216.90	$265.14
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $173.52 / $216.90 / $325.35	Professional		$173.52	$216.90	$325.35
United Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $387.22	Professional		$216.90	$216.90	$387.22