Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.61 / $28.61 / $101.40	Facility		$28.61	$28.61	$101.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $28.61 / $101.40	Professional		$14.05	$28.61	$101.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.03 / $56.65 / $149.77	Facility		$47.03	$56.65	$149.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $65.38 / $65.38	Professional		$35.14	$65.38	$65.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $192.81 / $282.95	Professional		$137.19	$192.81	$282.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10.75 / $10.75 / $10.75	Facility		$10.75	$10.75	$10.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $7.85 / $10.75	Professional		$7.85	$7.85	$10.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $21.28 / $25.54	Professional		$21.28	$21.28	$25.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $29.00 / $393.93	Professional		$25.00	$29.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $100.00	Facility		$90.00	$90.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $48.20 / $48.20 / $48.20	Professional		$48.20	$48.20	$48.20
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 $10.75 / $14.18 / $101.40	Facility		$10.75	$14.18	$101.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $7.85 / $10.75	Professional		$7.85	$7.85	$10.75
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $21.28 / $31.92	Professional		$21.28	$21.28	$31.92