Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,827.00 / $2,264.00 / $2,441.78	Facility		$1,827.00	$2,264.00	$2,441.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,785.56 / $2,441.78 / $3,355.00	Professional		$1,785.56	$2,441.78	$3,355.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.99 / $293.00 / $876.00	Facility		$55.99	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.34 / $2,156.11 / $3,453.97	Professional		$663.34	$2,156.11	$3,453.97
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $1,156.97 / $5,145.05	Facility		$59.40	$1,156.97	$5,145.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $460.47 / $657.82 / $1,552.72	Professional		$460.47	$657.82	$1,552.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $788.38 / $7,088.94 / $15,820.61	Facility		$788.38	$7,088.94	$15,820.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.50 / $641.49 / $1,224.92	Professional		$405.50	$641.49	$1,224.92
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $392.20 / $392.20 / $470.64	Professional		$392.20	$392.20	$470.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $562.78 / $705.88 / $1,375.92	Professional		$562.78	$705.88	$1,375.92
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $903.97 / $9,011.04 / $9,011.04	Facility		$903.97	$9,011.04	$9,011.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,842.18 / $6,869.73 / $6,869.73	Professional		$4,842.18	$6,869.73	$6,869.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $54.13	Professional		$32.34	$32.34	$54.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.18 / $812.89 / $3,556.30	Facility		$57.18	$812.89	$3,556.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $396.88 / $699.39 / $2,250,000.00	Professional		$396.88	$699.39	$2,250,000.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $588.29 / $795.35 / $972.09	Professional		$588.29	$795.35	$972.09
United Facility/Professional Facility Modifier Low / Median / High Price $717.70 / $2,838.06 / $2,838.06	Facility		$717.70	$2,838.06	$2,838.06
United Facility/Professional Professional Modifier Low / Median / High Price $448.91 / $1,681.78 / $4,337.76	Professional		$448.91	$1,681.78	$4,337.76