Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,195.20 / $1,195.20 / $1,195.20	Facility		$1,195.20	$1,195.20	$1,195.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,152.00 / $1,195.20 / $1,224.00	Professional		$1,152.00	$1,195.20	$1,224.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $376.67 / $448.48 / $758.80	Facility		$376.67	$448.48	$758.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.49 / $419.31 / $1,249.26	Professional		$386.49	$419.31	$1,249.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Facility		$1,224.00	$1,224.00	$1,224.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,224.00	Professional		$1,224.00	$1,224.00	$1,224.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $386.49 / $386.49 / $463.79	Professional		$386.49	$386.49	$463.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $393.93 / $801.00	Professional		$129.00	$393.93	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,368.00 / $2,880.00 / $5,400.00	Facility		$1,368.00	$2,880.00	$5,400.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,472.00 / $5,472.00 / $6,480.00	Professional		$5,472.00	$5,472.00	$6,480.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $521.76 / $792.30	Professional		$70.00	$521.76	$792.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $386.49 / $386.49 / $1,440.00	Facility		$386.49	$386.49	$1,440.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $1,224.00 / $1,440.00	Professional		$1,224.00	$1,224.00	$1,440.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $386.49 / $386.49 / $502.44	Professional		$386.49	$386.49	$502.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,200.00 / $1,200.00 / $2,409.23	Professional		$1,200.00	$1,200.00	$2,409.23