Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $961.45 / $961.45 / $961.45	Facility		$961.45	$961.45	$961.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $804.30 / $961.45 / $3,303.32	Professional		$804.30	$961.45	$3,303.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,400.00	Facility		$2,137.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,336.12 / $1,665.58 / $4,224.43	Professional		$1,336.12	$1,665.58	$4,224.43
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $100.00 / $15,838.91	Facility		$65.80	$100.00	$15,838.91
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $364.00 / $520.00 / $1,068.96	Professional		$364.00	$520.00	$1,068.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,738.49 / $4,904.76	Facility		$2,277.00	$2,738.49	$4,904.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,176.27 / $4,538.41 / $7,979.83	Professional		$3,176.27	$4,538.41	$7,979.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,955.09 / $1,955.09 / $2,052.84	Professional		$1,955.09	$1,955.09	$2,052.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $638.07 / $2,836.00 / $5,490.00	Professional		$638.07	$2,836.00	$5,490.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $14,212.24 / $21,368.21	Facility		$55.00	$14,212.24	$21,368.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $25,045.36 / $36,897.44 / $39,483.44	Professional		$25,045.36	$36,897.44	$39,483.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,167.20 / $6,998.44 / $8,851.73	Facility		$1,167.20	$6,998.44	$8,851.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,116.53 / $4,596.08 / $7,713.98	Professional		$3,116.53	$4,596.08	$7,713.98
United Facility/Professional Facility Modifier Low / Median / High Price $5,799.00 / $12,341.00 / $26,451.00	Facility		$5,799.00	$12,341.00	$26,451.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,661.48 / $2,888.61 / $6,940.35	Professional		$1,661.48	$2,888.61	$6,940.35