Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $90.64	Facility		$89.75	$89.75	$90.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $98.72	Professional		$89.75	$89.75	$98.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.54 / $95.63 / $161.80	Facility		$79.54	$95.63	$161.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.41 / $89.75 / $206.84	Professional		$82.41	$89.75	$206.84
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 $67.31 / $100.00 / $102.86	Professional		$67.31	$100.00	$102.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $84.67 / $89.75	Facility		$84.67	$84.67	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $103.34	Professional		$89.75	$89.75	$103.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $61.23 / $73.42 / $99.12	Professional		$61.23	$73.42	$99.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $112.19 / $197.45	Professional		$80.78	$112.19	$197.45
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 $67.35 / $99.11 / $150.51	Professional		$67.35	$99.11	$150.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $92.44 / $152.59	Facility		$89.75	$92.44	$152.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $125.69	Professional		$89.75	$89.75	$125.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $61.23 / $71.80 / $98.72	Professional		$61.23	$71.80	$98.72
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $180.19	Professional		$89.75	$89.75	$180.19