Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.84	Facility		$80.04	$80.04	$80.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $88.04	Professional		$80.04	$80.04	$88.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.01 / $92.88 / $157.13	Facility		$78.01	$92.88	$157.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $84.57 / $584.03	Professional		$80.04	$84.57	$584.03
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $100.00 / $1,445.35	Facility		$87.40	$100.00	$1,445.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.03 / $100.00 / $100.00	Professional		$60.03	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.51 / $75.51 / $80.04	Facility		$75.51	$75.51	$80.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $98.16	Professional		$80.04	$80.04	$98.16
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $624.34 / $686.77 / $842.86	Professional		$624.34	$686.77	$842.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $100.05 / $176.09	Professional		$74.84	$100.05	$176.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $500.65 / $883.50 / $2,756.52	Facility		$500.65	$883.50	$2,756.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,756.52 / $2,756.52 / $2,756.52	Professional		$2,756.52	$2,756.52	$2,756.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $842.85 / $1,279.89	Professional		$70.00	$842.85	$1,279.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $88.04 / $143.31	Facility		$80.04	$88.04	$143.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $749.21	Professional		$80.04	$80.04	$749.21
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $64.03 / $624.34 / $749.21	Professional		$64.03	$624.34	$749.21
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $164.96	Professional		$80.04	$80.04	$164.96