Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $553.94 / $553.94 / $559.47	Facility		$553.94	$553.94	$559.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $553.94 / $581.63	Professional		$553.94	$553.94	$581.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.05 / $226.08 / $382.51	Facility		$188.05	$226.08	$382.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.83 / $364.33 / $1,179.60	Professional		$194.83	$364.33	$1,179.60
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 / $1,194.18	Professional		$100.00	$100.00	$1,194.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $522.58 / $522.58 / $553.94	Facility		$522.58	$522.58	$553.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $553.94 / $600.97	Professional		$553.94	$553.94	$600.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $255.14 / $280.64 / $344.43	Professional		$255.14	$280.64	$344.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $498.54 / $692.41 / $1,207.57	Professional		$498.54	$692.41	$1,207.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,062.50 / $1,250.00 / $2,500.00	Facility		$1,062.50	$1,250.00	$2,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,805.51 / $2,321.37 / $4,750.00	Professional		$1,805.51	$2,321.37	$4,750.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $280.65 / $849.00 / $1,289.22	Professional		$280.65	$849.00	$1,289.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $553.94 / $581.63 / $943.63	Facility		$553.94	$581.63	$943.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $553.94 / $783.87	Professional		$553.94	$553.94	$783.87
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $255.14 / $306.17 / $609.33	Professional		$255.14	$306.17	$609.33
United Facility/Professional Professional Modifier Low / Median / High Price $553.94 / $553.94 / $1,129.00	Professional		$553.94	$553.94	$1,129.00