Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.12 / $163.77 / $163.77	Facility		$99.12	$163.77	$163.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.12 / $175.28 / $175.28	Professional		$99.12	$175.28	$175.28
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 $97.00 / $197.72 / $360.09	Facility		$97.00	$197.72	$360.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $100.00	Professional		$40.00	$40.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.98 / $92.98 / $92.98	Facility		$92.98	$92.98	$92.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.76 / $148.66 / $178.12	Professional		$83.76	$148.66	$178.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $107.51 / $107.51 / $129.01	Professional		$107.51	$107.51	$129.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.26 / $638.07 / $801.00	Professional		$118.26	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $92.98 / $100.00 / $100.00	Facility		$92.98	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $115.97 / $115.97	Professional		$115.97	$115.97	$115.97
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 $105.07 / $175.28 / $257.31	Facility		$105.07	$175.28	$257.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,800,000.00 / $2,400,000.00 / $2,400,000.00	Professional		$1,800,000.00	$2,400,000.00	$2,400,000.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $107.51 / $118.26 / $182.77	Professional		$107.51	$118.26	$182.77
United Facility/Professional Professional Modifier Low / Median / High Price $127.26 / $127.26 / $150.32	Professional		$127.26	$127.26	$150.32