Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $223.87	Professional		$162.18	$162.18	$223.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $204.17 / $512.86	Facility		$162.18	$204.17	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $467.74	Professional		$162.18	$177.83	$467.74
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $162.18	Facility		$151.36	$151.36	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $194.98	Professional		$162.18	$162.18	$194.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $199.53 / $239.88	Professional		$177.83	$199.53	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $269.15	Professional		$131.83	$173.78	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,995.26 / $1,995.26	Professional		$1,000.00	$1,995.26	$1,995.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $169.82 / $309.03	Facility		$162.18	$169.82	$309.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $213.80	Professional		$125.89	$125.89	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $251.19 / $371.54	Professional		$125.89	$251.19	$371.54