Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $744.93 / $744.93 / $744.93	Facility		$744.93	$744.93	$744.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $718.00 / $744.93 / $762.88	Professional		$718.00	$744.93	$762.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $743.50 / $885.25 / $1,497.76	Facility		$743.50	$885.25	$1,497.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $762.87 / $852.63 / $1,489.85	Professional		$762.87	$852.63	$1,489.85
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $268.36 / $479.21	Facility		$96.60	$268.36	$479.21
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $169.40 / $242.00 / $537.24	Professional		$169.40	$242.00	$537.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $762.88 / $762.88 / $762.88	Facility		$762.88	$762.88	$762.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $762.88 / $866.81	Professional		$762.88	$762.88	$866.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $311.36 / $311.36 / $373.63	Professional		$311.36	$311.36	$373.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $393.93 / $801.00	Professional		$129.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $897.50 / $1,795.00 / $3,365.63	Facility		$897.50	$1,795.00	$3,365.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,410.50 / $3,410.50 / $4,038.75	Professional		$3,410.50	$3,410.50	$4,038.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $342.49 / $1,998.15 / $1,998.15	Professional		$342.49	$1,998.15	$1,998.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $718.00 / $919.55 / $1,032.13	Facility		$718.00	$919.55	$1,032.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $762.88 / $762.88 / $1,320.00	Professional		$762.88	$762.88	$1,320.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $311.36 / $311.36 / $404.77	Professional		$311.36	$311.36	$404.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,997.50 / $1,997.50 / $4,015.97	Professional		$1,997.50	$1,997.50	$4,015.97