Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $758.58 / $1,905.46	Facility		$302.00	$758.58	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $426.58	Professional		$295.12	$302.00	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.03 / $363.08 / $676.08	Facility		$0.03	$363.08	$676.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $588.84	Professional		$302.00	$323.59	$588.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $380.19 / $1,479.11	Facility		$100.00	$380.19	$1,479.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $245.47	Professional		$87.10	$120.23	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $346.74 / $380.19	Professional		$97.72	$346.74	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $380.19 / $776.25	Facility		$309.03	$380.19	$776.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $363.08	Professional		$309.03	$309.03	$363.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $165.96	Professional		$97.72	$128.82	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $1,513.56 / $1,513.56	Facility		$275.42	$1,513.56	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $602.56	Professional		$302.00	$302.00	$602.56