Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $768.00 / $861.88 / $861.88	Facility		$768.00	$861.88	$861.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.95 / $749.84 / $905.49	Professional		$656.95	$749.84	$905.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $708.16 / $708.16 / $708.16	Professional		$708.16	$708.16	$708.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.37 / $293.00 / $876.00	Facility		$63.37	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $605.09 / $802.61 / $1,589.48	Professional		$605.09	$802.61	$1,589.48
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $819.06 / $1,609.07	Facility		$97.00	$819.06	$1,609.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $584.65 / $835.22 / $1,861.04	Professional		$584.65	$835.22	$1,861.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $572.51 / $666.37 / $2,015.72	Facility		$572.51	$666.37	$2,015.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $668.28 / $1,075.70 / $2,293.98	Professional		$668.28	$1,075.70	$2,293.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $588.82 / $588.82 / $706.58	Professional		$588.82	$588.82	$706.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $708.92 / $905.84 / $1,589.00	Professional		$708.92	$905.84	$1,589.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,587.78 / $3,468.16 / $3,967.91	Facility		$1,587.78	$3,468.16	$3,967.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,680.93 / $4,680.93 / $6,400.13	Professional		$4,680.93	$4,680.93	$6,400.13
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 $708.66 / $945.79 / $1,269.25	Facility		$708.66	$945.79	$1,269.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $714.65 / $1,033.99 / $1,889.20	Professional		$714.65	$1,033.99	$1,889.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $765.46 / $905.77 / $1,107.05	Professional		$765.46	$905.77	$1,107.05
United Facility/Professional Facility Modifier Low / Median / High Price $879.02 / $905.51 / $905.51	Facility		$879.02	$905.51	$905.51
United Facility/Professional Professional Modifier Low / Median / High Price $589.54 / $842.72 / $1,984.93	Professional		$589.54	$842.72	$1,984.93