Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $475.00 / $1,632.00 / $3,923.00	Facility		$475.00	$1,632.00	$3,923.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.75 / $425.00 / $475.00	Professional		$318.75	$425.00	$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 / $637.20	Professional		$311.38	$311.38	$637.20
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $900.73 / $2,030.83	Facility		$97.00	$900.73	$2,030.83
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 $1,471.54 / $1,471.54 / $1,471.54	Professional		$1,471.54	$1,471.54	$1,471.54
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 $393.93 / $638.07 / $801.00	Professional		$393.93	$638.07	$801.00
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 $1,681.60 / $1,681.60 / $1,681.60	Professional		$1,681.60	$1,681.60	$1,681.60
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 / $425.00 / $1,064.00	Facility		$318.75	$425.00	$1,064.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,471.54 / $1,471.54 / $1,471.54	Professional		$1,471.54	$1,471.54	$1,471.54
United Facility/Professional Facility Modifier Low / Median / High Price $567.79 / $588.75 / $905.15	Facility		$567.79	$588.75	$905.15