Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.97 / $19.97 / $54.21	Facility		$19.97	$19.97	$54.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $21.97	Professional		$19.97	$19.97	$21.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.32 / $24.19 / $40.93	Facility		$20.32	$24.19	$40.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $21.89 / $49.18	Professional		$19.97	$21.89	$49.18
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $49.44 / $49.44 / $49.44	Facility		$49.44	$49.44	$49.44
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 $18.84 / $18.84 / $19.97	Facility		$18.84	$18.84	$19.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $24.49	Professional		$19.97	$19.97	$24.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $20.56 / $27.75	Professional		$18.55	$20.56	$27.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $24.96 / $43.93	Professional		$18.55	$24.96	$43.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $90.79 / $90.79	Facility		$75.00	$90.79	$90.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $90.79 / $90.79 / $90.79	Professional		$90.79	$90.79	$90.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.40 / $28.78 / $70.00	Professional		$20.40	$28.78	$70.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $19.97 / $21.97 / $34.15	Facility		$19.97	$21.97	$34.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $26.13	Professional		$19.97	$19.97	$26.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $15.98 / $18.55 / $22.26	Professional		$15.98	$18.55	$22.26
United Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $40.09	Professional		$19.97	$19.97	$40.09