Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,466.78	Facility		$1,452.25	$1,452.25	$1,466.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,597.48	Professional		$1,452.25	$1,452.25	$1,597.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,665.01 / $2,001.74 / $3,386.77	Facility		$1,665.01	$2,001.74	$3,386.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,822.69 / $4,282.82	Professional		$1,452.25	$1,822.69	$4,282.82
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 / $1,161.80	Professional		$100.00	$100.00	$1,161.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,370.05 / $1,370.05 / $1,452.25	Facility		$1,370.05	$1,370.05	$1,452.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $1,781.06	Professional		$1,452.25	$1,452.25	$1,781.06
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,557.99 / $1,713.79 / $2,103.29	Professional		$1,557.99	$1,713.79	$2,103.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,307.03 / $1,815.31 / $3,165.91	Professional		$1,307.03	$1,815.31	$3,165.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,550.00 / $6,878.66 / $6,878.66	Facility		$2,550.00	$6,878.66	$6,878.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,878.66 / $6,878.66 / $6,878.66	Professional		$6,878.66	$6,878.66	$6,878.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,713.78 / $2,103.28 / $3,193.87	Professional		$1,713.78	$2,103.28	$3,193.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,452.25 / $1,540.12 / $2,473.37	Facility		$1,452.25	$1,540.12	$2,473.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,055.07	Professional		$1,452.25	$1,452.25	$2,055.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,161.80 / $1,557.99 / $1,869.59	Professional		$1,161.80	$1,557.99	$1,869.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,452.25 / $1,452.25 / $2,813.30	Professional		$1,452.25	$1,452.25	$2,813.30