Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $71.55 / $72.27	Facility		$71.55	$71.55	$72.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $75.13	Professional		$71.55	$71.55	$75.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $83.03 / $140.47	Facility		$69.73	$83.03	$140.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $75.59 / $168.75	Professional		$71.55	$75.59	$168.75
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $0.70 / $1.00 / $2.50	Professional		$0.70	$1.00	$2.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.50 / $67.50 / $71.55	Facility		$67.50	$67.50	$71.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $77.62	Professional		$71.55	$71.55	$77.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $23.40 / $23.40 / $28.08	Professional		$23.40	$23.40	$28.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.40 / $89.44 / $157.41	Professional		$64.40	$89.44	$157.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.18 / $202.50 / $390.68	Facility		$104.18	$202.50	$390.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $364.63 / $395.88 / $468.81	Professional		$364.63	$395.88	$468.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.74 / $77.08 / $77.08	Professional		$25.74	$77.08	$77.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $72.27 / $119.49	Facility		$71.55	$72.27	$119.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $83.15	Professional		$71.55	$71.55	$83.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $23.40 / $28.08 / $78.70	Professional		$23.40	$28.08	$78.70
United Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $134.04	Professional		$71.55	$71.55	$134.04