Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $188.70 / $192.67 / $192.67	Facility		$188.70	$192.67	$192.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.74 / $146.74 / $192.67	Professional		$146.74	$146.74	$192.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $357.00 / $1,294.00 / $1,610.00	Facility		$357.00	$1,294.00	$1,610.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.36 / $203.33 / $650.00	Professional		$180.36	$203.33	$650.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $225.83 / $532.78	Facility		$97.00	$225.83	$532.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $100.00	Professional		$40.00	$40.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $64.00 / $64.00	Facility		$64.00	$64.00	$64.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.57 / $259.57 / $259.57	Professional		$259.57	$259.57	$259.57
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $147.13 / $176.56	Professional		$147.13	$147.13	$176.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.84 / $638.07 / $801.00	Professional		$161.84	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $279.54	Facility		$100.00	$100.00	$279.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $422.40 / $422.40 / $422.40	Professional		$422.40	$422.40	$422.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $146.74 / $155.54 / $349.24	Facility		$146.74	$155.54	$349.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,800,000.00 / $2,400,000.00 / $2,400,000.00	Professional		$1,800,000.00	$2,400,000.00	$2,400,000.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $161.84 / $250.12	Professional		$147.13	$161.84	$250.12
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $249.47 / $249.47	Professional		$45.00	$249.47	$249.47