Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.39 / $135.66 / $135.66	Facility		$116.39	$135.66	$135.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $85.13 / $135.66	Professional		$60.21	$85.13	$135.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.60 / $136.81 / $361.72	Facility		$113.60	$136.81	$361.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $157.91 / $157.91	Professional		$118.14	$157.91	$157.91
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $314.55 / $442.09 / $648.77	Professional		$314.55	$442.09	$648.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.50 / $56.50 / $149.97	Facility		$56.50	$56.50	$149.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $41.25 / $58.20	Professional		$41.25	$41.25	$58.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $157.91 / $189.50	Professional		$157.91	$157.91	$189.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $638.07 / $801.00	Professional		$157.91	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $294.27 / $662.25 / $662.25	Facility		$294.27	$662.25	$662.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $846.32 / $880.17 / $1,021.13	Professional		$846.32	$880.17	$1,021.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.84 / $122.38 / $218.67	Facility		$59.84	$122.38	$218.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $41.25 / $58.20	Professional		$41.25	$41.25	$58.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $157.91 / $236.88	Professional		$157.91	$157.91	$236.88
United Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $78.17 / $184.40	Professional		$72.09	$78.17	$184.40