Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $577.57 / $971.67 / $3,452.39	Facility		$577.57	$971.67	$3,452.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $503.72 / $577.57 / $672.33	Professional		$503.72	$577.57	$672.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $536.91 / $591.12	Professional		$500.00	$536.91	$591.12
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 $522.64 / $773.64 / $1,589.48	Professional		$522.64	$773.64	$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 $424.22 / $606.03 / $1,350.36	Professional		$424.22	$606.03	$1,350.36
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 $541.12 / $843.64 / $1,905.33	Professional		$541.12	$843.64	$1,905.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $729.59 / $729.59 / $875.51	Professional		$729.59	$729.59	$875.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $514.83 / $657.83 / $1,206.59	Professional		$514.83	$657.83	$1,206.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,285.70 / $2,808.14 / $3,212.90	Facility		$1,285.70	$2,808.14	$3,212.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,792.87 / $3,792.87 / $5,181.83	Professional		$3,792.87	$3,792.87	$5,181.83
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 $565.32 / $702.09 / $935.15	Facility		$565.32	$702.09	$935.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $566.24 / $753.76 / $1,432.78	Professional		$566.24	$753.76	$1,432.78
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $583.91 / $802.88 / $1,240.30	Professional		$583.91	$802.88	$1,240.30
United Facility/Professional Facility Modifier Low / Median / High Price $656.97 / $843.60 / $1,344.81	Facility		$656.97	$843.60	$1,344.81
United Facility/Professional Professional Modifier Low / Median / High Price $429.51 / $623.24 / $1,497.67	Professional		$429.51	$623.24	$1,497.67