Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $475.00 / $1,197.08 / $3,894.00	Facility		$475.00	$1,197.08	$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 $636.79 / $636.79 / $4,457.60	Professional		$636.79	$636.79	$4,457.60
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 / $961.00 / $3,605.00	Facility		$412.15	$961.00	$3,605.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,098.77 / $1,098.77 / $1,098.77	Professional		$1,098.77	$1,098.77	$1,098.77
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 / $415.00 / $638.07	Professional		$415.00	$415.00	$638.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $2,647.01	Facility		$100.00	$100.00	$2,647.01
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,352.33 / $1,352.33 / $1,352.33	Professional		$1,352.33	$1,352.33	$1,352.33
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 / $2,400,000.00 / $2,400,000.00	Professional		$1,800,000.00	$2,400,000.00	$2,400,000.00