Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $3,801.89 / $6,165.95	Facility		$2,754.23	$3,801.89	$6,165.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,862.09 / $4,897.79	Professional		$1,819.70	$1,862.09	$4,897.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,187.76 / $4,786.30	Facility		$1,905.46	$2,187.76	$4,786.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $6,025.60	Professional		$1,819.70	$1,905.46	$6,025.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $2,398.83 / $4,073.80	Facility		$85.11	$2,398.83	$4,073.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,398.83 / $6,309.57	Professional		$1,819.70	$2,398.83	$6,309.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,819.70	Facility		$1,737.80	$1,737.80	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,905.46 / $4,168.69	Professional		$1,659.59	$1,905.46	$4,168.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $15,135.61 / $15,135.61 / $15,135.61	Facility		$15,135.61	$15,135.61	$15,135.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $2,818.38 / $4,570.88	Facility		$1,862.09	$2,818.38	$4,570.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $3,981.07	Professional		$1,862.09	$1,862.09	$3,981.07
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Professional		$5,370.32	$5,370.32	$5,370.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,041.74 / $3,162.28	Professional		$1,479.11	$2,041.74	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $10,715.19 / $10,715.19	Facility		$1,819.70	$10,715.19	$10,715.19
United Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $4,466.84	Professional		$1,819.70	$1,819.70	$4,466.84