Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.45 / $99.45 / $99.45	Facility		$99.45	$99.45	$99.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.28 / $58.28 / $99.45	Professional		$58.28	$58.28	$99.45
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 / $197.55 / $370.84	Facility		$97.00	$197.55	$370.84
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 $117.06 / $117.06 / $117.06	Facility		$117.06	$117.06	$117.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.90 / $114.90 / $114.90	Professional		$114.90	$114.90	$114.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $121.72 / $121.72 / $146.06	Professional		$121.72	$121.72	$146.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $638.07 / $801.00	Professional		$133.88	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $150.85	Facility		$100.00	$100.00	$150.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $178.61 / $178.61 / $178.61	Professional		$178.61	$178.61	$178.61
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 $58.28 / $99.45 / $142.21	Facility		$58.28	$99.45	$142.21
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 $121.72 / $133.88 / $206.92	Professional		$121.72	$133.88	$206.92
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $137.36 / $137.36	Professional		$68.48	$137.36	$137.36