Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.38 / $86.13 / $114.78	Professional		$45.38	$86.13	$114.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $89.61 / $99.21	Professional		$71.45	$89.61	$99.21
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $100.00 / $115.93	Professional		$70.00	$100.00	$115.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.70 / $84.48 / $85.47	Facility		$76.70	$84.48	$85.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $76.70 / $76.70	Professional		$76.70	$76.70	$76.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $37.50	Professional		$25.00	$25.00	$37.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.00 / $179.00 / $367.00	Professional		$156.00	$179.00	$367.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $179.28 / $179.28 / $511.81	Facility		$179.28	$179.28	$511.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $605.40 / $605.40 / $789.23	Professional		$605.40	$605.40	$789.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.06 / $102.29 / $162.22	Facility		$67.06	$102.29	$162.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $76.70 / $76.70	Professional		$76.70	$76.70	$76.70
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $37.50 / $37.50	Professional		$25.00	$37.50	$37.50
United Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $93.66 / $260.02	Professional		$75.33	$93.66	$260.02