Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,047.13 / $1,071.52	Facility		$912.01	$1,047.13	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,047.13 / $1,096.48	Professional		$912.01	$1,047.13	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $3,311.31	Facility		$1,047.13	$1,318.26	$3,311.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,047.13 / $2,398.83	Professional		$794.33	$1,047.13	$2,398.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $691.83 / $2,344.23	Facility		$63.10	$691.83	$2,344.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $134.90	Professional		$95.50	$125.89	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,047.13	Facility		$1,000.00	$1,000.00	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $1,047.13 / $1,380.38	Professional		$208.93	$1,047.13	$1,380.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $269.15	Professional		$131.83	$173.78	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $4,466.84	Professional		$4,466.84	$4,466.84	$4,466.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $1,047.13 / $1,479.11	Facility		$165.96	$1,047.13	$1,479.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $371.54	Professional		$125.89	$125.89	$371.54
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $309.03	Professional		$147.91	$208.93	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $269.15 / $1,000.00	Professional		$125.89	$269.15	$1,000.00