Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $796.80 / $1,920.00 / $5,013.12	Facility		$796.80	$1,920.00	$5,013.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $662.40 / $796.80 / $7,438.76	Professional		$662.40	$796.80	$7,438.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $848.72 / $1,824.77 / $4,090.51	Facility		$848.72	$1,824.77	$4,090.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.19 / $816.00 / $1,593.60	Professional		$197.19	$816.00	$1,593.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $98.70 / $1,800.00	Facility		$76.20	$98.70	$1,800.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,163.97 / $1,163.97 / $3,272.39	Professional		$1,163.97	$1,163.97	$3,272.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $816.00 / $816.00 / $816.00	Facility		$816.00	$816.00	$816.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $816.00 / $816.00 / $816.00	Professional		$816.00	$816.00	$816.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $4,120.00 / $5,935.00	Professional		$393.93	$4,120.00	$5,935.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,740.19 / $14,196.10 / $14,196.10	Facility		$2,740.19	$14,196.10	$14,196.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.58 / $816.00 / $1,142.41	Facility		$85.58	$816.00	$1,142.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $816.00 / $816.00	Professional		$48.08	$816.00	$816.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $5,053.81 / $5,053.81 / $5,053.81	Professional		$5,053.81	$5,053.81	$5,053.81
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $1,040.00 / $1,360.00	Professional		$800.00	$1,040.00	$1,360.00
United Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $800.00 / $1,777.17	Professional		$800.00	$800.00	$1,777.17