Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.69 / $157.69 / $157.69	Facility		$157.69	$157.69	$157.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $157.69 / $161.50	Professional		$152.00	$157.69	$161.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.25 / $76.48 / $129.41	Facility		$64.25	$76.48	$129.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $72.51 / $161.50	Professional		$65.92	$72.51	$161.50
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $91.89 / $91.89 / $91.89	Professional		$91.89	$91.89	$91.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.50 / $161.50 / $161.50	Facility		$161.50	$161.50	$161.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.50 / $161.50 / $161.50	Professional		$161.50	$161.50	$161.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $129.62 / $129.62 / $155.54	Professional		$129.62	$129.62	$155.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $393.93 / $801.00	Professional		$129.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $180.50 / $380.00 / $712.50	Facility		$180.50	$380.00	$712.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $722.00 / $722.00 / $855.00	Professional		$722.00	$722.00	$855.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $136.83	Professional		$60.00	$60.00	$136.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.92 / $65.92 / $190.00	Facility		$65.92	$65.92	$190.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.50 / $161.50 / $203.25	Professional		$161.50	$161.50	$203.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $129.62 / $129.62 / $168.51	Professional		$129.62	$129.62	$168.51
United Facility/Professional Professional Modifier Low / Median / High Price $167.51 / $167.51 / $318.07	Professional		$167.51	$167.51	$318.07