Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,378.42 / $4,378.42 / $36,778.69	Facility		$4,378.42	$4,378.42	$36,778.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,639.89 / $4,378.42 / $4,483.93	Professional		$3,639.89	$4,378.42	$4,483.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,844.97 / $4,708.13 / $5,389.68	Facility		$3,844.97	$4,708.13	$5,389.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,730.95 / $4,483.93 / $8,429.78	Professional		$1,730.95	$4,483.93	$8,429.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,534.49 / $2,192.13 / $5,343.76	Professional		$1,534.49	$2,192.13	$5,343.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,483.93 / $4,483.93 / $4,483.93	Facility		$4,483.93	$4,483.93	$4,483.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,483.93 / $4,483.93 / $4,483.93	Professional		$4,483.93	$4,483.93	$4,483.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,252.27 / $2,252.27 / $2,702.72	Professional		$2,252.27	$2,252.27	$2,702.72
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 $4,483.93 / $7,187.97 / $7,450.04	Facility		$4,483.93	$7,187.97	$7,450.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,220.54 / $10,220.54 / $11,487.38	Professional		$10,220.54	$10,220.54	$11,487.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $5,432.47	Professional		$85.00	$85.00	$5,432.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,002.29 / $4,483.93 / $5,275.21	Facility		$1,002.29	$4,483.93	$5,275.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $4,483.93 / $4,483.93 / $4,483.93	Professional		$4,483.93	$4,483.93	$4,483.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,252.27 / $2,477.50 / $3,828.86	Professional		$2,252.27	$2,477.50	$3,828.86
United Facility/Professional Professional Modifier Low / Median / High Price $5,275.21 / $5,275.21 / $10,133.68	Professional		$5,275.21	$5,275.21	$10,133.68