Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $662.69	Facility		$656.12	$656.12	$662.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $688.93	Professional		$656.12	$656.12	$688.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,062.38 / $1,264.92 / $2,140.13	Facility		$1,062.38	$1,264.92	$2,140.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.77 / $1,090.07 / $2,396.10	Professional		$276.77	$1,090.07	$2,396.10
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $524.90	Professional		$100.00	$100.00	$524.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $618.98 / $618.98 / $656.12	Facility		$618.98	$618.98	$656.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $804.68	Professional		$656.12	$656.12	$804.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $166.13 / $166.13 / $199.36	Professional		$166.13	$166.13	$199.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $590.51 / $820.15 / $1,430.34	Professional		$590.51	$820.15	$1,430.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $2,502.00 / $2,915.49	Facility		$1,417.80	$2,502.00	$2,915.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,838.00 / $5,838.00 / $5,838.00	Professional		$5,838.00	$5,838.00	$5,838.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $1,260.03	Professional		$60.00	$60.00	$1,260.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $695.82 / $1,129.60	Facility		$656.12	$695.82	$1,129.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $1,668.00	Professional		$656.12	$656.12	$1,668.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $166.13 / $199.36 / $721.74	Professional		$166.13	$199.36	$721.74
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $1,337.96	Professional		$656.12	$656.12	$1,337.96