Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $742.40	Facility		$735.05	$735.05	$742.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $808.55	Professional		$735.05	$735.05	$808.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $784.91 / $943.65 / $1,596.58	Facility		$784.91	$943.65	$1,596.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $859.24 / $2,291.96	Professional		$735.05	$859.24	$2,291.96
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 / $588.04	Professional		$100.00	$100.00	$588.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $693.44 / $693.44 / $735.05	Facility		$693.44	$693.44	$735.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $901.47	Professional		$735.05	$735.05	$901.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $972.83 / $1,070.11 / $1,313.33	Professional		$972.83	$1,070.11	$1,313.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $661.55 / $918.81 / $1,602.41	Professional		$661.55	$918.81	$1,602.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,887.00 / $4,295.12 / $4,440.00	Facility		$1,887.00	$4,295.12	$4,440.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,295.12 / $4,295.12 / $8,436.00	Professional		$4,295.12	$4,295.12	$8,436.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,070.11 / $1,994.30 / $1,994.30	Professional		$1,070.11	$1,994.30	$1,994.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $808.55 / $1,265.52	Facility		$735.05	$808.55	$1,265.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $1,216.04	Professional		$735.05	$735.05	$1,216.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $588.04 / $972.83 / $1,167.40	Professional		$588.04	$972.83	$1,167.40
United Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $2,014.40	Professional		$735.05	$735.05	$2,014.40