Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $112.26	Facility		$111.15	$111.15	$112.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $122.27	Professional		$111.15	$111.15	$122.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.73 / $151.15 / $255.74	Facility		$125.73	$151.15	$255.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $141.31 / $556.79	Professional		$111.15	$141.31	$556.79
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 $83.36 / $100.00 / $396.80	Professional		$83.36	$100.00	$396.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.86 / $104.86 / $111.15	Facility		$104.86	$104.86	$111.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $136.32	Professional		$111.15	$111.15	$136.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $317.83 / $363.79 / $491.11	Professional		$317.83	$363.79	$491.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.93 / $138.94 / $251.89	Professional		$103.93	$138.94	$251.89
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $474.00 / $1,606.18 / $1,606.18	Facility		$474.00	$1,606.18	$1,606.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,606.18 / $1,606.18 / $1,606.18	Professional		$1,606.18	$1,606.18	$1,606.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $491.11 / $509.30 / $745.76	Professional		$491.11	$509.30	$745.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $122.27 / $205.26	Facility		$111.15	$122.27	$205.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $454.74	Professional		$111.15	$111.15	$454.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $88.92 / $317.83 / $381.41	Professional		$88.92	$317.83	$381.41
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $228.46	Professional		$111.15	$111.15	$228.46