Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $555.20 / $555.20 / $560.75	Facility		$555.20	$555.20	$560.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $555.20 / $605.16	Professional		$555.20	$555.20	$605.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,726.21 / $3,277.55 / $5,545.34	Facility		$2,726.21	$3,277.55	$5,545.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $2,877.79 / $6,419.06	Professional		$555.20	$2,877.79	$6,419.06
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 / $1,544.13	Professional		$100.00	$100.00	$1,544.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $523.78 / $523.78 / $555.20	Facility		$523.78	$523.78	$555.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $555.20 / $680.91	Professional		$555.20	$555.20	$680.91
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $119.42 / $119.42 / $143.30	Professional		$119.42	$119.42	$143.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $499.68 / $694.00 / $1,210.33	Professional		$499.68	$694.00	$1,210.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,290.75 / $4,042.50 / $7,916.34	Facility		$2,290.75	$4,042.50	$7,916.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,432.50 / $10,423.18 / $10,658.48	Professional		$9,432.50	$10,423.18	$10,658.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.36 / $1,495.39 / $2,270.78	Professional		$131.36	$1,495.39	$2,270.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $555.20 / $610.72 / $995.65	Facility		$555.20	$610.72	$995.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $555.20 / $1,956.25	Professional		$555.20	$555.20	$1,956.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $119.42 / $143.30 / $610.72	Professional		$119.42	$143.30	$610.72
United Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $555.20 / $1,878.91	Professional		$555.20	$555.20	$1,878.91