Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.10 / $17.10 / $17.10	Facility		$17.10	$17.10	$17.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.10 / $17.10 / $17.10	Professional		$17.10	$17.10	$17.10
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 / $122.70 / $177.11	Facility		$92.60	$122.70	$177.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
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 $203.99 / $203.99 / $203.99	Professional		$203.99	$203.99	$203.99
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $52.64 / $63.17	Professional		$52.64	$52.64	$63.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $638.07 / $801.00	Professional		$57.90	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $219.68	Facility		$100.00	$100.00	$219.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $282.45 / $282.45 / $282.45	Professional		$282.45	$282.45	$282.45
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 $17.10 / $17.10 / $36.18	Facility		$17.10	$17.10	$36.18
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 $52.64 / $57.90 / $89.49	Professional		$52.64	$57.90	$89.49
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00