Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $561.74 / $561.74 / $4,718.62	Facility		$561.74	$561.74	$4,718.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.47 / $561.74 / $561.74	Professional		$254.47	$561.74	$561.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $493.30 / $604.04 / $691.49	Facility		$493.30	$604.04	$691.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.74 / $575.28 / $1,109.95	Professional		$389.74	$575.28	$1,109.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.13 / $178.75 / $435.74	Professional		$125.13	$178.75	$435.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Facility		$358.29	$358.29	$358.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Professional		$358.29	$358.29	$358.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $168.04 / $168.04 / $201.65	Professional		$168.04	$168.04	$201.65
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 $757.62 / $1,887.15 / $1,924.16	Facility		$757.62	$1,887.15	$1,924.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,621.34 / $2,621.34 / $3,685.80	Professional		$2,621.34	$2,621.34	$3,685.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $558.85	Professional		$85.00	$85.00	$558.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $358.29 / $541.88 / $711.44	Facility		$358.29	$541.88	$711.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $358.29 / $358.29 / $358.29	Professional		$358.29	$358.29	$358.29
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $168.04 / $184.84 / $285.67	Professional		$168.04	$184.84	$285.67
United Facility/Professional Professional Modifier Low / Median / High Price $676.80 / $676.80 / $1,267.92	Professional		$676.80	$676.80	$1,267.92