Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $75.79 / $76.55	Facility		$75.79	$75.79	$76.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $83.37	Professional		$75.79	$75.79	$83.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $96.52 / $163.31	Facility		$80.29	$96.52	$163.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $98.09 / $1,046.50	Professional		$75.79	$98.09	$1,046.50
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 $56.84 / $100.00 / $857.03	Professional		$56.84	$100.00	$857.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.50 / $71.50 / $75.79	Facility		$71.50	$71.50	$75.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $85.80	Professional		$75.79	$75.79	$85.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $119.43 / $131.37 / $161.22	Professional		$119.43	$131.37	$161.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.86 / $94.74 / $174.32	Professional		$70.86	$94.74	$174.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $969.00 / $1,140.00 / $1,140.00	Facility		$969.00	$1,140.00	$1,140.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,311.00 / $1,311.00 / $1,311.00	Professional		$1,311.00	$1,311.00	$1,311.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.37 / $161.23 / $244.83	Professional		$131.37	$161.23	$244.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $83.37 / $135.78	Facility		$75.79	$83.37	$135.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $181.20	Professional		$75.79	$75.79	$181.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.63 / $119.43 / $143.32	Professional		$60.63	$119.43	$143.32
United Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $75.79 / $152.16	Professional		$75.79	$75.79	$152.16