Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.55 / $14.55 / $145.32	Facility		$14.55	$14.55	$145.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.02 / $14.55 / $16.64	Professional		$14.02	$14.55	$16.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.21 / $65.15 / $74.58	Facility		$53.21	$65.15	$74.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $129.06	Professional		$62.05	$62.05	$129.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $30.98 / $77.88	Professional		$21.69	$30.98	$77.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.05 / $62.05 / $62.05	Facility		$62.05	$62.05	$62.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $62.05	Professional		$62.05	$62.05	$62.05
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $24.33 / $29.20	Professional		$24.33	$24.33	$29.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $638.07	Professional		$100.00	$100.00	$638.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $90.00 / $100.00	Facility		$80.00	$90.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $93.09 / $93.09 / $99.28	Professional		$93.09	$93.09	$99.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $65.77 / $134.82	Professional		$60.00	$65.77	$134.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.02 / $16.01 / $62.05	Facility		$14.02	$16.01	$62.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $62.05	Professional		$62.05	$62.05	$62.05
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $24.33 / $36.50	Professional		$24.33	$24.33	$36.50
United Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $91.21	Professional		$62.05	$62.05	$91.21