Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $65.88 / $66.54	Facility		$65.88	$65.88	$66.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $72.47	Professional		$65.88	$65.88	$72.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.66 / $76.98 / $130.26	Facility		$64.66	$76.98	$130.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $71.98 / $186.99	Professional		$65.88	$71.98	$186.99
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 $62.15 / $62.15 / $65.88	Facility		$62.15	$62.15	$65.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $80.80	Professional		$65.88	$65.88	$80.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $70.45 / $86.46	Professional		$64.05	$70.45	$86.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.60 / $82.35 / $144.94	Professional		$61.60	$82.35	$144.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $282.77 / $360.00	Facility		$153.00	$282.77	$360.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,978.60 / $3,978.60 / $3,978.60	Professional		$3,978.60	$3,978.60	$3,978.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $85.00 / $85.00	Professional		$70.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $72.47 / $113.63	Facility		$65.88	$72.47	$113.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $165.00	Professional		$65.88	$65.88	$165.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $162.72	Professional		$65.88	$65.88	$162.72