Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,089.16	Facility		$2,068.46	$2,068.46	$2,089.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,171.90	Professional		$2,068.46	$2,068.46	$2,171.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,164.17 / $2,576.75 / $4,359.64	Facility		$2,164.17	$2,576.75	$4,359.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $455.99 / $2,220.57 / $4,881.07	Professional		$455.99	$2,220.57	$4,881.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Professional		$40.00	$40.00	$40.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,951.39 / $1,951.39 / $2,068.46	Facility		$1,951.39	$1,951.39	$2,068.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $2,244.10	Professional		$2,068.46	$2,068.46	$2,244.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $176.06 / $176.06 / $211.27	Professional		$176.06	$176.06	$211.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,861.62 / $2,585.59 / $4,509.26	Professional		$1,861.62	$2,585.59	$4,509.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,825.40 / $4,986.00 / $6,648.00	Facility		$2,825.40	$4,986.00	$6,648.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,634.00 / $12,631.20 / $14,958.00	Professional		$11,634.00	$12,631.20	$14,958.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $237.68 / $360.92	Professional		$70.00	$237.68	$360.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,068.46 / $2,171.90 / $3,522.75	Facility		$2,068.46	$2,171.90	$3,522.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $3,324.00	Professional		$2,068.46	$2,068.46	$3,324.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $176.06 / $211.27 / $2,275.32	Professional		$176.06	$211.27	$2,275.32
United Facility/Professional Professional Modifier Low / Median / High Price $2,068.46 / $2,068.46 / $4,083.16	Professional		$2,068.46	$2,068.46	$4,083.16