Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.53 / $67.73 / $194.68	Facility		$43.53	$67.73	$194.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $36.11 / $81.19	Professional		$36.11	$36.11	$81.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $357.00 / $1,294.00 / $1,610.00	Facility		$357.00	$1,294.00	$1,610.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $122.88 / $222.40	Facility		$95.50	$122.88	$222.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $65.70 / $78.75 / $167.12	Professional		$65.70	$78.75	$167.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.11 / $190.11 / $190.11	Facility		$190.11	$190.11	$190.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $21.70	Professional		$21.70	$21.70	$21.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.03 / $67.03 / $80.44	Professional		$67.03	$67.03	$80.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $638.07 / $801.00	Professional		$73.73	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $225.16	Facility		$100.00	$100.00	$225.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $144.21 / $144.21 / $144.21	Professional		$144.21	$144.21	$144.21
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 $43.53 / $64.95 / $97.66	Facility		$43.53	$64.95	$97.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $104.15	Professional		$21.70	$21.70	$104.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.03 / $73.73 / $113.95	Professional		$67.03	$73.73	$113.95
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $79.29 / $79.29	Professional		$45.00	$79.29	$79.29