Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $475.00 / $1,210.85 / $3,894.00	Facility		$475.00	$1,210.85	$3,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $425.63 / $475.00	Professional		$318.75	$425.63	$475.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.00 / $614.00 / $2,393.00	Facility		$203.00	$614.00	$2,393.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $311.38 / $311.38 / $699.50	Professional		$311.38	$311.38	$699.50
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $735.12 / $1,657.43	Facility		$97.00	$735.12	$1,657.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $412.15 / $998.29 / $3,605.00	Facility		$412.15	$998.29	$3,605.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $440.00 / $440.00 / $1,079.31	Professional		$440.00	$440.00	$1,079.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $283.74 / $283.74 / $283.74	Professional		$283.74	$283.74	$283.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $415.00 / $427.19 / $525.00	Professional		$415.00	$427.19	$525.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,520.96 / $2,647.01	Facility		$100.00	$2,520.96	$2,647.01
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,328.38 / $1,328.38 / $1,328.38	Professional		$1,328.38	$1,328.38	$1,328.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $85.00	Professional		$30.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $318.75 / $425.63 / $1,064.00	Facility		$318.75	$425.63	$1,064.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,800,000.00 / $2,250,000.00 / $2,400,000.00	Professional		$1,800,000.00	$2,250,000.00	$2,400,000.00