Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,011.11 / $2,841.81 / $4,208.28	Professional		$2,011.11	$2,841.81	$4,208.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $337.69 / $374.17 / $374.17	Facility		$337.69	$374.17	$374.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,617.98 / $3,651.66 / $4,655.25	Professional		$2,617.98	$3,651.66	$4,655.25
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $867.71 / $867.71 / $867.71	Facility		$867.71	$867.71	$867.71
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,673.00 / $2,673.00 / $2,673.00	Facility		$2,673.00	$2,673.00	$2,673.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,272.05 / $2,673.00 / $5,073.75	Professional		$2,272.05	$2,673.00	$5,073.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $4,057.40 / $4,057.40 / $4,868.88	Professional		$4,057.40	$4,057.40	$4,868.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $638.07 / $3,192.88 / $3,854.53	Professional		$638.07	$3,192.88	$3,854.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $4,920.35 / $4,920.35	Facility		$65.00	$4,920.35	$4,920.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,673.00 / $2,916.93 / $4,126.80	Facility		$2,673.00	$2,916.93	$4,126.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,272.05 / $2,673.00 / $3,931.29	Professional		$2,272.05	$2,673.00	$3,931.29
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $4,057.40 / $4,057.40 / $4,057.40	Professional		$4,057.40	$4,057.40	$4,057.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,596.44 / $1,824.44 / $3,043.05	Professional		$1,596.44	$1,824.44	$3,043.05