Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,808.65 / $3,618.88 / $4,062.55	Facility		$1,808.65	$3,618.88	$4,062.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,826.73 / $3,922.01	Professional		$1,808.65	$1,826.73	$3,922.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,854.68 / $2,888.94 / $6,476.02	Facility		$1,854.68	$2,888.94	$6,476.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,809.44 / $3,977.36	Professional		$1,808.65	$1,809.44	$3,977.36
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $2,108.21	Facility		$77.09	$100.00	$2,108.21
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,842.77 / $1,842.77 / $4,570.07	Professional		$1,842.77	$1,842.77	$4,570.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,706.27 / $1,706.27 / $1,808.65	Facility		$1,706.27	$1,706.27	$1,808.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $1,808.65	Professional		$1,808.65	$1,808.65	$1,808.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,627.79 / $2,170.38 / $3,979.03	Professional		$1,627.79	$2,170.38	$3,979.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,405.84 / $9,043.25 / $9,060.04	Facility		$2,405.84	$9,043.25	$9,060.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,706.27 / $1,808.65 / $2,567.34	Facility		$1,706.27	$1,808.65	$2,567.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $3,912.11	Professional		$1,808.65	$1,808.65	$3,912.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,664.57 / $2,664.57 / $2,664.57	Professional		$2,664.57	$2,664.57	$2,664.57
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,446.92 / $1,989.51 / $3,074.70	Professional		$1,446.92	$1,989.51	$3,074.70
United Facility/Professional Professional Modifier Low / Median / High Price $1,808.65 / $1,808.65 / $3,717.50	Professional		$1,808.65	$1,808.65	$3,717.50