Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $182.18 / $184.00	Facility		$182.18	$182.18	$184.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $200.40	Professional		$182.18	$182.18	$200.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.84 / $211.40 / $357.67	Facility		$175.84	$211.40	$357.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $192.49 / $457.27	Professional		$182.18	$192.49	$457.27
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 $171.87 / $171.87 / $182.18	Facility		$171.87	$171.87	$182.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $254.70	Professional		$182.18	$182.18	$254.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $200.40 / $245.94	Professional		$182.18	$200.40	$245.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.96 / $227.73 / $400.80	Professional		$163.96	$227.73	$400.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $804.35 / $804.35	Facility		$425.00	$804.35	$804.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $804.35 / $804.35 / $804.35	Professional		$804.35	$804.35	$804.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $373.46 / $373.46	Professional		$70.00	$373.46	$373.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $200.40 / $313.60	Facility		$182.18	$200.40	$313.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $257.80	Professional		$182.18	$182.18	$257.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,817.63 / $1,915.57 / $1,915.57	Facility		$1,817.63	$1,915.57	$1,915.57
United Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $349.97	Professional		$182.18	$182.18	$349.97