Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $870.96 / $3,548.13	Facility		$562.34	$870.96	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $954.99	Professional		$691.83	$691.83	$954.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $630.96	Professional		$30.20	$30.20	$630.96
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,584.89 / $2,089.30	Facility		$100.00	$1,584.89	$2,089.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $75.86	Professional		$39.81	$39.81	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $741.31	Professional		$630.96	$630.96	$741.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $630.96 / $831.76	Professional		$128.82	$630.96	$831.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility		$2,754.23	$2,754.23	$2,754.23
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $851.14 / $1,479.11	Facility		$741.31	$851.14	$1,479.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $741.31 / $1,071.52	Professional		$630.96	$741.31	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,096.48 / $1,698.24	Facility		$1,047.13	$1,096.48	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $630.96	Professional		$436.52	$436.52	$630.96