Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $1,464.66 / $4,756.89	Facility		$540.00	$1,464.66	$4,756.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.40 / $540.00 / $612.00	Professional		$392.40	$540.00	$612.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.00 / $614.00 / $3,607.20	Facility		$244.00	$614.00	$3,607.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $254.07 / $439.20	Professional		$228.90	$254.07	$439.20
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.90 / $983.52 / $6,537.60	Facility		$59.90	$983.52	$6,537.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $327.60 / $468.00 / $689.97	Professional		$327.60	$468.00	$689.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.15 / $945.36 / $2,356.38	Facility		$482.15	$945.36	$2,356.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $827.24 / $877.63 / $1,097.04	Professional		$827.24	$877.63	$1,097.04
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $720.00 / $1,152.00	Professional		$99.00	$720.00	$1,152.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $576.00 / $720.00 / $1,260.00	Professional		$576.00	$720.00	$1,260.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,252.80 / $3,420.00 / $3,420.00	Facility		$1,252.80	$3,420.00	$3,420.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $432.00 / $720.00 / $1,719.44	Facility		$432.00	$720.00	$1,719.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $554.40 / $684.00 / $720.00	Professional		$554.40	$684.00	$720.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $576.00 / $720.00 / $1,008.00	Professional		$576.00	$720.00	$1,008.00
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $1,144.80	Professional		$302.39	$302.39	$1,144.80