Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $66.07 / $66.07	Facility		$64.57	$66.07	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $91.20	Professional		$64.57	$64.57	$91.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $83.18 / $208.93	Facility		$66.07	$83.18	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $199.53	Professional		$66.07	$85.11	$199.53
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Facility		$147.91	$147.91	$147.91
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 $61.66 / $61.66 / $66.07	Facility		$61.66	$61.66	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $74.13	Professional		$66.07	$66.07	$74.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $72.44 / $89.13	Professional		$66.07	$72.44	$89.13
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 $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $3,981.07 / $3,981.07	Professional		$3,981.07	$3,981.07	$3,981.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $95.50 / $218.78	Facility		$66.07	$95.50	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $138.04	Professional		$125.89	$125.89	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $199.53	Professional		$125.89	$151.36	$199.53