Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $670.26	Facility		$663.63	$663.63	$670.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $729.99	Professional		$663.63	$663.63	$729.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $699.55 / $832.91 / $1,409.22	Facility		$699.55	$832.91	$1,409.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $758.41 / $2,022.99	Professional		$663.63	$758.41	$2,022.99
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $100.00 / $1,445.35	Facility		$87.40	$100.00	$1,445.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $530.90	Professional		$100.00	$100.00	$530.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $626.05 / $626.05 / $663.63	Facility		$626.05	$626.05	$663.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $813.88	Professional		$663.63	$663.63	$813.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $858.92 / $944.81 / $1,159.54	Professional		$858.92	$944.81	$1,159.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $597.27 / $829.54 / $1,459.99	Professional		$597.27	$829.54	$1,459.99
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $882.76 / $1,215.45 / $3,792.20	Facility		$882.76	$1,215.45	$3,792.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,792.20 / $3,792.20 / $3,800.00	Professional		$3,792.20	$3,792.20	$3,800.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $85.00 / $85.00	Professional		$70.00	$85.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $729.99 / $1,130.35	Facility		$663.63	$729.99	$1,130.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $1,073.65	Professional		$663.63	$663.63	$1,073.65
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $530.90 / $858.92 / $1,030.70	Professional		$530.90	$858.92	$1,030.70
United Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $1,354.60	Professional		$663.63	$663.63	$1,354.60