Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,905.46 / $11,481.54	Facility		$645.65	$1,905.46	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $575.44 / $691.83	Professional		$489.78	$575.44	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $707.95 / $1,122.02	Professional		$602.56	$707.95	$1,122.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $72.44 / $74.13	Facility		$64.57	$72.44	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,949.84	Professional		$602.56	$870.96	$1,949.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,230.27 / $1,621.81	Facility		$100.00	$1,230.27	$1,621.81
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,445.44	Professional		$575.44	$724.44	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $660.69 / $1,995.26	Facility		$575.44	$660.69	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $831.76 / $1,905.46	Professional		$562.34	$831.76	$1,905.46
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $870.96	Professional		$724.44	$724.44	$870.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $630.96 / $1,122.02	Professional		$501.19	$630.96	$1,122.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $3,801.89 / $3,801.89	Facility		$3,801.89	$3,801.89	$3,801.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $5,128.61 / $5,128.61	Professional		$3,801.89	$5,128.61	$5,128.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $691.83 / $1,023.29	Facility		$549.54	$691.83	$1,023.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $794.33 / $1,513.56	Professional		$398.11	$794.33	$1,513.56
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $794.33 / $1,230.27	Professional		$588.84	$794.33	$1,230.27
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $616.60 / $933.25	Facility		$588.84	$616.60	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $630.96 / $1,288.25	Professional		$446.68	$630.96	$1,288.25