Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $346.74	Facility		$77.62	$77.62	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $302.00	Professional		$77.62	$77.62	$302.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $97.72 / $245.47	Facility		$77.62	$97.72	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $223.87	Professional		$77.62	$87.10	$223.87
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $162.18	Professional		$72.44	$95.50	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $77.62	Facility		$74.13	$74.13	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
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 $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $107.15 / $223.87	Facility		$77.62	$107.15	$223.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $147.91	Professional		$77.62	$125.89	$147.91