Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.87 / $496.87 / $4,781.38	Facility		$496.87	$496.87	$4,781.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.91 / $496.87 / $508.84	Professional		$478.91	$496.87	$508.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $529.25 / $1,395.78 / $2,876.94	Facility		$529.25	$1,395.78	$2,876.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $498.87 / $508.84 / $993.74	Professional		$498.87	$508.84	$993.74
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $348.19 / $1,358.08	Facility		$92.60	$348.19	$1,358.08
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $493.08 / $493.08 / $493.08	Professional		$493.08	$493.08	$493.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $508.84 / $508.84 / $508.84	Facility		$508.84	$508.84	$508.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $508.84 / $508.84 / $508.84	Professional		$508.84	$508.84	$508.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $498.87 / $498.87 / $598.64	Professional		$498.87	$498.87	$598.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.00 / $393.93 / $801.00	Professional		$127.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $568.71 / $2,493.10 / $4,369.20	Facility		$568.71	$2,493.10	$4,369.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,274.83 / $2,274.83 / $2,693.88	Professional		$2,274.83	$2,274.83	$2,693.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $508.84 / $598.64 / $752.32	Facility		$508.84	$598.64	$752.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $508.84 / $508.84 / $723.39	Professional		$508.84	$508.84	$723.39
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $498.87 / $498.87 / $648.53	Professional		$498.87	$498.87	$648.53
United Facility/Professional Professional Modifier Low / Median / High Price $498.87 / $498.87 / $947.25	Professional		$498.87	$498.87	$947.25