Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $69.17	Facility		$68.48	$68.48	$69.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $79.44	Professional		$68.48	$68.48	$79.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.75 / $79.48 / $134.47	Facility		$66.75	$79.48	$134.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $72.36 / $184.48	Professional		$68.48	$72.36	$184.48
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 $64.61 / $64.61 / $68.48	Facility		$64.61	$64.61	$68.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Professional		$68.48	$68.48	$68.48
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $75.34 / $92.46	Professional		$68.48	$75.34	$92.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $85.61 / $150.68	Professional		$64.04	$85.61	$150.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $91.10 / $302.37 / $302.37	Facility		$91.10	$302.37	$302.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.37 / $302.37 / $335.66	Professional		$302.37	$302.37	$335.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $92.46 / $140.40	Professional		$70.00	$92.46	$140.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $73.69 / $116.77	Facility		$68.48	$73.69	$116.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $85.61	Professional		$68.48	$68.48	$85.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $68.48 / $89.04	Professional		$54.79	$68.48	$89.04
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $123.43	Professional		$68.48	$68.48	$123.43