Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.70 / $70.70 / $71.40	Facility		$70.70	$70.70	$71.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $73.52	Professional		$70.70	$70.70	$73.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.23 / $82.43 / $139.47	Facility		$69.23	$82.43	$139.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $75.06 / $200.23	Professional		$70.70	$75.06	$200.23
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 $53.03 / $100.00 / $205.14	Professional		$53.03	$100.00	$205.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.69 / $66.69 / $70.70	Facility		$66.69	$66.69	$70.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $86.70	Professional		$70.70	$70.70	$86.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $72.64 / $79.91 / $98.07	Professional		$72.64	$79.91	$98.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $88.38 / $162.61	Professional		$66.09	$88.38	$162.61
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $320.72 / $344.25	Facility		$255.00	$320.72	$344.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $345.00 / $405.09 / $453.26	Professional		$345.00	$405.09	$453.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $70.00 / $148.91	Professional		$60.00	$70.00	$148.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.70 / $77.77 / $124.05	Facility		$70.70	$77.77	$124.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $185.09	Professional		$70.70	$70.70	$185.09
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $72.64 / $87.17	Professional		$56.56	$72.64	$87.17
United Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $141.94	Professional		$70.70	$70.70	$141.94