Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,054.40 / $3,054.40 / $3,054.40	Facility		$3,054.40	$3,054.40	$3,054.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,944.00 / $3,054.40 / $3,128.00	Professional		$2,944.00	$3,054.40	$3,128.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $511.56 / $615.01 / $1,040.55	Facility		$511.56	$615.01	$1,040.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $530.00 / $625.00 / $1,760.00	Professional		$530.00	$625.00	$1,760.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $738.82 / $738.82 / $738.82	Professional		$738.82	$738.82	$738.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,128.00 / $3,128.00 / $3,128.00	Facility		$3,128.00	$3,128.00	$3,128.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,128.00 / $3,128.00 / $3,128.00	Professional		$3,128.00	$3,128.00	$3,128.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $530.00 / $530.00 / $636.00	Professional		$530.00	$530.00	$636.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $456.00 / $1,242.00	Professional		$288.00	$456.00	$1,242.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,354.70 / $3,900.80 / $5,347.50	Facility		$1,354.70	$3,900.80	$5,347.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,991.00 / $7,728.00 / $14,536.00	Professional		$4,991.00	$7,728.00	$14,536.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $583.00 / $715.50 / $1,086.50	Professional		$583.00	$715.50	$1,086.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $530.00 / $530.00 / $3,278.88	Facility		$530.00	$530.00	$3,278.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $675.00 / $3,128.00 / $3,128.00	Professional		$675.00	$3,128.00	$3,128.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $530.00 / $530.00 / $689.00	Professional		$530.00	$530.00	$689.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,200.00 / $3,200.00 / $6,147.20	Professional		$3,200.00	$3,200.00	$6,147.20