Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $741.31 / $891.25	Professional		$724.44	$741.31	$891.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $954.99 / $2,398.83	Facility		$758.58	$954.99	$2,398.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $1,445.44	Professional		$758.58	$891.25	$1,445.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $263.03 / $478.63	Facility		$97.72	$263.03	$478.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $537.03	Professional		$218.78	$295.12	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $371.54	Professional		$309.03	$309.03	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $831.76	Professional		$120.23	$141.25	$831.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,073.80	Professional		$4,073.80	$4,073.80	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $977.24	Professional		$338.84	$338.84	$977.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $912.01 / $1,318.26	Facility		$691.83	$912.01	$1,318.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $891.25	Professional		$758.58	$758.58	$891.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $371.54 / $524.81	Professional		$309.03	$371.54	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $6,760.83 / $6,760.83	Facility		$6,760.83	$6,760.83	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,511.89	Professional		$1,995.26	$1,995.26	$2,511.89