Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $5,128.61 / $12,022.64	Facility		$1,995.26	$5,128.61	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $5,128.61 / $6,165.95	Professional		$4,897.79	$5,128.61	$6,165.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,888.44 / $10,232.93	Facility		$5,248.07	$5,888.44	$10,232.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,128.61 / $5,370.32 / $9,772.37	Professional		$5,128.61	$5,370.32	$9,772.37
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $3,548.13	Professional		$1,258.93	$1,737.80	$3,548.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility		$5,248.07	$5,248.07	$5,248.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Professional		$5,248.07	$5,248.07	$5,248.07
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $5,888.44 / $5,888.44 / $7,943.28	Professional		$5,888.44	$5,888.44	$7,943.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $398.11	Professional		$100.00	$100.00	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $18,197.01 / $18,197.01 / $18,197.01	Facility		$18,197.01	$18,197.01	$18,197.01
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $27,542.29 / $27,542.29 / $27,542.29	Professional		$27,542.29	$27,542.29	$27,542.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $6,165.95 / $10,471.29	Facility		$3,162.28	$6,165.95	$10,471.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Professional		$5,248.07	$5,248.07	$5,248.07
United Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $8,128.31 / $8,128.31	Facility		$2,344.23	$8,128.31	$8,128.31
United Facility/Professional Professional Modifier Low / Median / High Price $5,128.61 / $5,128.61 / $9,772.37	Professional		$5,128.61	$5,128.61	$9,772.37