Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $415.00 / $415.00 / $3,486.00	Facility		$415.00	$415.00	$3,486.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.00 / $415.00 / $425.00	Professional		$345.00	$415.00	$425.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $448.72 / $478.73 / $542.40	Facility		$448.72	$478.73	$542.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.60 / $451.25 / $879.93	Professional		$368.60	$451.25	$879.93
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $332.50 / $475.00 / $1,157.91	Professional		$332.50	$475.00	$1,157.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $432.81 / $432.81 / $432.81	Facility		$432.81	$432.81	$432.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.81 / $432.81 / $432.81	Professional		$432.81	$432.81	$432.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $380.00 / $456.00	Professional		$380.00	$380.00	$456.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $393.93 / $393.93	Professional		$393.93	$393.93	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,011.44 / $2,785.98 / $2,887.57	Facility		$1,011.44	$2,785.98	$2,887.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,061.82 / $3,061.82 / $4,452.38	Professional		$3,061.82	$3,061.82	$4,452.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $415.00 / $432.81 / $844.99	Facility		$415.00	$432.81	$844.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $432.81 / $432.81 / $432.81	Professional		$432.81	$432.81	$432.81
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $418.00 / $646.00	Professional		$380.00	$418.00	$646.00
United Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $500.00 / $949.50	Professional		$500.00	$500.00	$949.50