Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $1,949.84	Facility		$112.20	$112.20	$1,949.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $1,737.80	Professional		$112.20	$112.20	$1,737.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $354.81	Facility		$112.20	$141.25	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $954.99	Professional		$112.20	$123.03	$954.99
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $407.38 / $2,344.23	Facility		$64.57	$407.38	$2,344.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $416.87 / $758.58	Professional		$100.00	$416.87	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $112.20	Facility		$107.15	$107.15	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $138.04	Professional		$112.20	$112.20	$138.04
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $269.15	Professional		$112.20	$169.82	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $269.15	Professional		$131.83	$173.78	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $144.54 / $295.12	Facility		$112.20	$144.54	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $295.12	Professional		$125.89	$125.89	$295.12
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $234.42 / $354.81	Professional		$147.91	$234.42	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $812.83	Professional		$125.89	$257.04	$812.83