Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $722.00 / $722.00 / $5,513.42	Facility		$722.00	$722.00	$5,513.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.22 / $722.00 / $722.00	Professional		$600.22	$722.00	$722.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $604.96 / $771.00 / $1,043.85	Facility		$604.96	$771.00	$1,043.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $664.73 / $711.72 / $1,290.58	Professional		$664.73	$711.72	$1,290.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $98.87 / $239.77	Professional		$87.01	$98.87	$239.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $739.40 / $739.40 / $739.40	Facility		$739.40	$739.40	$739.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $739.40 / $739.40 / $739.40	Professional		$739.40	$739.40	$739.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $659.00 / $659.00 / $790.80	Professional		$659.00	$659.00	$790.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $554.00 / $841.00 / $1,253.00	Professional		$554.00	$841.00	$1,253.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $948.96 / $1,581.60 / $2,965.50	Facility		$948.96	$1,581.60	$2,965.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,005.04 / $3,005.04 / $3,558.60	Professional		$3,005.04	$3,005.04	$3,558.60
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 $722.00 / $869.88 / $1,034.11	Facility		$722.00	$869.88	$1,034.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $739.40 / $739.40 / $855.00	Professional		$739.40	$739.40	$855.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $659.00 / $724.90 / $1,120.30	Professional		$659.00	$724.90	$1,120.30
United Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $85.80 / $302.77	Professional		$85.80	$85.80	$302.77