Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.00 / $318.00 / $321.18	Facility		$318.00	$318.00	$321.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $349.80	Professional		$318.00	$318.00	$349.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.92 / $369.01 / $624.33	Facility		$309.92	$369.01	$624.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $345.00 / $1,331.11	Professional		$318.00	$345.00	$1,331.11
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 / $254.40	Professional		$100.00	$100.00	$254.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $318.00	Facility		$300.00	$300.00	$318.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $390.00	Professional		$318.00	$318.00	$390.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $370.86 / $407.95 / $500.67	Professional		$370.86	$407.95	$500.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.20 / $397.50 / $731.40	Professional		$286.20	$397.50	$731.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,232.50 / $1,637.39 / $2,027.14	Facility		$1,232.50	$1,637.39	$2,027.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,994.29 / $1,994.29 / $1,994.29	Professional		$1,994.29	$1,994.29	$1,994.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $500.66 / $760.26	Professional		$70.00	$500.66	$760.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $318.00 / $349.80 / $547.54	Facility		$318.00	$349.80	$547.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $465.73	Professional		$318.00	$318.00	$465.73
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $254.40 / $370.86 / $445.03	Professional		$254.40	$370.86	$445.03
United Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $318.00 / $677.28	Professional		$318.00	$318.00	$677.28