Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $139.31	Facility		$137.93	$137.93	$139.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $151.72	Professional		$137.93	$137.93	$151.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.84 / $126.02 / $213.21	Facility		$105.84	$126.02	$213.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $137.93 / $313.14	Professional		$108.60	$137.93	$313.14
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 $118.34 / $169.06 / $347.54	Professional		$118.34	$169.06	$347.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.12 / $130.12 / $137.93	Facility		$130.12	$130.12	$137.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $232.71 / $255.98 / $314.16	Professional		$232.71	$255.98	$314.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.14 / $172.41 / $303.45	Professional		$124.14	$172.41	$303.45
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $170.37 / $329.31 / $1,027.45	Facility		$170.37	$329.31	$1,027.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,027.45 / $1,027.45 / $1,027.45	Professional		$1,027.45	$1,027.45	$1,027.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $314.15 / $477.05	Professional		$70.00	$314.15	$477.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $151.72 / $237.29	Facility		$137.93	$151.72	$237.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $195.18	Professional		$137.93	$137.93	$195.18
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $329.40	Professional		$137.93	$137.93	$329.40