Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $110.53	Facility		$109.44	$109.44	$110.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $120.38	Professional		$109.44	$109.44	$120.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.58 / $150.97 / $255.44	Facility		$125.58	$150.97	$255.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $137.47 / $366.72	Professional		$109.44	$137.47	$366.72
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 $82.08 / $100.00 / $285.52	Professional		$82.08	$100.00	$285.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.24 / $103.24 / $109.44	Facility		$103.24	$103.24	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $134.21	Professional		$109.44	$109.44	$134.21
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $265.14 / $357.94	Professional		$69.62	$265.14	$357.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.50 / $136.80 / $251.71	Professional		$98.50	$136.80	$251.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $1,668.00 / $1,668.00	Facility		$1,417.80	$1,668.00	$1,668.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,668.00 / $1,884.84 / $1,884.84	Professional		$1,668.00	$1,884.84	$1,884.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.58 / $357.93 / $543.53	Professional		$76.58	$357.93	$543.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $120.38 / $196.11	Facility		$109.44	$120.38	$196.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $331.43	Professional		$109.44	$109.44	$331.43
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $83.54 / $120.38	Professional		$69.62	$83.54	$120.38
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $233.09	Professional		$109.44	$109.44	$233.09