Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,184.28	Facility		$1,172.56	$1,172.56	$1,184.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,231.19	Professional		$1,172.56	$1,172.56	$1,231.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.44 / $256.61 / $434.16	Facility		$213.44	$256.61	$434.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.14 / $309.58 / $1,172.56	Professional		$221.14	$309.58	$1,172.56
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 / $879.42	Professional		$100.00	$100.00	$879.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,106.19 / $1,106.19 / $1,172.56	Facility		$1,106.19	$1,106.19	$1,172.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,272.10	Professional		$1,172.56	$1,172.56	$1,272.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $96.19 / $96.19 / $115.43	Professional		$96.19	$96.19	$115.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,055.30 / $1,465.70 / $2,556.17	Professional		$1,055.30	$1,465.70	$2,556.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,559.73 / $3,375.00 / $3,675.00	Facility		$1,559.73	$3,375.00	$3,675.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,725.00 / $4,725.00 / $4,725.00	Professional		$4,725.00	$4,725.00	$4,725.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.80 / $1,402.38 / $2,129.54	Professional		$105.80	$1,402.38	$2,129.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,172.56 / $1,207.73 / $1,996.63	Facility		$1,172.56	$1,207.73	$1,996.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,334.40	Professional		$1,172.56	$1,172.56	$1,334.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $96.19 / $115.43 / $1,289.81	Professional		$96.19	$115.43	$1,289.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $2,127.48	Professional		$1,172.56	$1,172.56	$2,127.48