Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $161.62 / $163.24	Facility		$161.62	$161.62	$163.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $187.48	Professional		$161.62	$161.62	$187.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.65 / $191.28 / $323.63	Facility		$160.65	$191.28	$323.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $174.16 / $413.74	Professional		$161.62	$174.16	$413.74
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 $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.47 / $152.47 / $161.62	Facility		$152.47	$152.47	$161.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $198.22	Professional		$161.62	$161.62	$198.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $171.81 / $188.99 / $231.94	Professional		$171.81	$188.99	$231.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $145.46 / $202.03 / $355.56	Professional		$145.46	$202.03	$355.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $379.65 / $758.53 / $1,674.94	Facility		$379.65	$758.53	$1,674.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,004.96 / $1,697.27 / $2,009.93	Professional		$1,004.96	$1,697.27	$2,009.93
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 $161.62 / $177.79 / $282.83	Facility		$161.62	$177.79	$282.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $345.00	Professional		$161.62	$161.62	$345.00
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $324.48	Professional		$161.62	$161.62	$324.48