Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $487.59 / $487.59 / $492.46	Facility		$487.59	$487.59	$492.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $487.59 / $487.59 / $536.34	Professional		$487.59	$487.59	$536.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $475.21 / $565.79 / $957.29	Facility		$475.21	$565.79	$957.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $487.59 / $515.19 / $1,374.22	Professional		$487.59	$515.19	$1,374.22
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.30 / $100.00 / $1,445.35	Facility		$87.30	$100.00	$1,445.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $390.07	Professional		$100.00	$100.00	$390.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.99 / $459.99 / $487.59	Facility		$459.99	$459.99	$487.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.59 / $487.59 / $597.98	Professional		$487.59	$487.59	$597.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $346.64 / $381.31 / $467.97	Professional		$346.64	$381.31	$467.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $438.83 / $609.49 / $1,062.95	Professional		$438.83	$609.49	$1,062.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $833.00 / $1,530.45 / $1,921.69	Facility		$833.00	$1,530.45	$1,921.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,386.13 / $2,386.13 / $3,067.88	Professional		$2,386.13	$2,386.13	$3,067.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $467.96 / $710.61	Professional		$70.00	$467.96	$710.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $487.59 / $502.21 / $839.41	Facility		$487.59	$502.21	$839.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $487.59 / $487.59 / $903.33	Professional		$487.59	$487.59	$903.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $346.64 / $390.07 / $536.34	Professional		$346.64	$390.07	$536.34
United Facility/Professional Professional Modifier Low / Median / High Price $487.59 / $487.59 / $978.93	Professional		$487.59	$487.59	$978.93