Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $954.99 / $2,884.03	Facility		$416.87	$954.99	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,089.30 / $2,137.96	Facility		$1,047.13	$2,089.30	$2,137.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $645.65 / $1,096.48	Professional		$257.04	$645.65	$1,096.48
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $1,000.00 / $4,073.80	Facility		$61.66	$1,000.00	$4,073.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $512.86	Professional		$169.82	$223.87	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $602.56 / $1,380.38	Facility		$281.84	$602.56	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $562.34	Professional		$239.88	$416.87	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $457.09 / $724.44	Professional		$371.54	$457.09	$724.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $3,090.30 / $3,090.30	Professional		$2,089.30	$3,090.30	$3,090.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $501.19 / $1,023.29	Facility		$416.87	$501.19	$1,023.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $457.09 / $630.96	Professional		$416.87	$457.09	$630.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $416.87	Professional		$239.88	$331.13	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $416.87 / $416.87	Facility		$173.78	$416.87	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $186.21 / $912.01	Professional		$173.78	$186.21	$912.01