Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $748.85 / $1,485.80 / $1,667.96	Facility		$748.85	$1,485.80	$1,667.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $750.32 / $1,276.30	Professional		$400.00	$750.32	$1,276.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $767.80 / $1,196.14 / $2,681.33	Facility		$767.80	$1,196.14	$2,681.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.53 / $748.85 / $1,632.96	Professional		$226.53	$748.85	$1,632.96
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.20 / $100.00 / $875.68	Facility		$77.20	$100.00	$875.68
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $762.97 / $762.97 / $1,886.06	Professional		$762.97	$762.97	$1,886.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $706.46 / $706.46 / $748.84	Facility		$706.46	$706.46	$748.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Professional		$748.84	$748.84	$748.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $673.97 / $898.62 / $1,647.47	Professional		$673.97	$898.62	$1,647.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $950.71 / $3,573.60 / $3,744.25	Facility		$950.71	$3,573.60	$3,744.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $706.46 / $748.84 / $1,063.03	Facility		$706.46	$748.84	$1,063.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.85 / $1,619.76	Professional		$748.84	$748.85	$1,619.76
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,131.48 / $1,131.48 / $1,131.48	Professional		$1,131.48	$1,131.48	$1,131.48
United Facility/Professional Facility Modifier Low / Median / High Price $748.84 / $1,988.60 / $1,988.60	Facility		$748.84	$1,988.60	$1,988.60
United Facility/Professional Professional Modifier Low / Median / High Price $748.85 / $748.85 / $1,539.19	Professional		$748.85	$748.85	$1,539.19