Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,008.90 / $4,008.90 / $4,008.90	Facility		$4,008.90	$4,008.90	$4,008.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,864.00 / $4,008.90 / $4,105.50	Professional		$3,864.00	$4,008.90	$4,105.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,864.71 / $3,444.07 / $5,827.07	Facility		$2,864.71	$3,444.07	$5,827.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $3,500.00 / $8,346.24	Professional		$2,968.00	$3,500.00	$8,346.24
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $4,137.39 / $4,137.39 / $4,137.39	Professional		$4,137.39	$4,137.39	$4,137.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Professional		$4,105.50	$4,105.50	$4,105.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $2,968.00 / $3,561.60	Professional		$2,968.00	$2,968.00	$3,561.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $2,968.00 / $9,158.00	Professional		$393.93	$2,968.00	$9,158.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,830.00 / $9,660.00 / $18,112.50	Facility		$4,830.00	$9,660.00	$18,112.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $16,905.00 / $18,354.00 / $21,735.00	Professional		$16,905.00	$18,354.00	$21,735.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,264.80 / $4,006.80 / $6,084.40	Professional		$3,264.80	$4,006.80	$6,084.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,968.00 / $2,968.00 / $4,830.00	Facility		$2,968.00	$2,968.00	$4,830.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,558.80 / $4,105.50 / $4,105.50	Professional		$3,558.80	$4,105.50	$4,105.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $2,968.00 / $3,858.40	Professional		$2,968.00	$2,968.00	$3,858.40
United Facility/Professional Professional Modifier Low / Median / High Price $4,200.00 / $4,200.00 / $7,475.16	Professional		$4,200.00	$4,200.00	$7,475.16