Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.50 / $81.00 / $105.84	Facility		$40.50	$81.00	$105.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.38 / $92.37 / $114.73	Professional		$56.38	$92.37	$114.73
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 $92.60 / $112.04 / $201.58	Facility		$92.60	$112.04	$201.58
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 $64.00 / $64.00 / $64.00	Facility		$64.00	$64.00	$64.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.62 / $1.62 / $1.62	Professional		$1.62	$1.62	$1.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $77.93 / $77.93 / $93.52	Professional		$77.93	$77.93	$93.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.72 / $638.07 / $801.00	Professional		$85.72	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $100.00 / $166.25	Facility		$80.00	$100.00	$166.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $197.12 / $197.12 / $197.12	Professional		$197.12	$197.12	$197.12
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 $56.38 / $109.25 / $126.80	Facility		$56.38	$109.25	$126.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $1.62 / $1.62 / $1.62	Professional		$1.62	$1.62	$1.62
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $77.93 / $85.72 / $132.47	Professional		$77.93	$85.72	$132.47
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $79.29 / $79.29	Professional		$45.00	$79.29	$79.29