Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $477.00 / $1,554.59 / $4,030.65	Facility		$477.00	$1,554.59	$4,030.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $477.00 / $477.00 / $2,685.51	Professional		$477.00	$477.00	$2,685.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.00 / $614.00 / $15,828.69	Facility		$244.00	$614.00	$15,828.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.00 / $239.20 / $392.14	Professional		$208.00	$239.20	$392.14
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $4,187.60 / $5,008.39 / $6,102.80	Facility		$4,187.60	$5,008.39	$6,102.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,437.53 / $2,053.62 / $5,135.08	Professional		$1,437.53	$2,053.62	$5,135.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,084.42 / $5,298.34 / $10,576.14	Facility		$2,084.42	$5,298.34	$10,576.14
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,527.54 / $3,159.42 / $4,265.22	Professional		$2,527.54	$3,159.42	$4,265.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,843.48 / $3,633.33 / $6,034.49	Professional		$2,843.48	$3,633.33	$6,034.49
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,497.39 / $15,007.25 / $15,007.25	Facility		$5,497.39	$15,007.25	$15,007.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $15,733.91 / $15,733.91 / $23,695.65	Professional		$15,733.91	$15,733.91	$23,695.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,053.62 / $3,791.30 / $8,382.87	Facility		$2,053.62	$3,791.30	$8,382.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,159.42 / $3,475.36 / $4,739.13	Professional		$3,159.42	$3,475.36	$4,739.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,527.54 / $2,843.48 / $4,296.82	Professional		$2,527.54	$2,843.48	$4,296.82
United Facility/Professional Professional Modifier Low / Median / High Price $1,326.96 / $1,326.96 / $7,607.57	Professional		$1,326.96	$1,326.96	$7,607.57