Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $91.54 / $92.45	Facility		$91.54	$91.54	$92.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $100.69	Professional		$91.54	$91.54	$100.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $78.58 / $132.94	Facility		$66.00	$78.58	$132.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.72 / $91.54 / $171.52	Professional		$67.72	$91.54	$171.52
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 $86.36 / $86.36 / $91.54	Facility		$86.36	$86.36	$91.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $100.37	Professional		$91.54	$91.54	$100.37
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $69.04 / $93.21	Professional		$63.38	$69.04	$93.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.39 / $114.43 / $201.39	Professional		$82.39	$114.43	$201.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $136.00 / $304.81 / $304.81	Facility		$136.00	$304.81	$304.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $304.81 / $304.81 / $304.81	Professional		$304.81	$304.81	$304.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.71 / $93.20 / $141.53	Professional		$69.71	$93.20	$141.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $92.45 / $155.90	Facility		$91.54	$92.45	$155.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.89 / $91.54 / $100.37	Professional		$81.89	$91.54	$100.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $73.23 / $100.69	Professional		$63.38	$73.23	$100.69
United Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $183.78	Professional		$91.54	$91.54	$183.78